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

{"title":"Frequency and Patterns of Multidrug-Resistant Organisms among Ventilated Patients During the Coronavirus Disease-19 Pandemic.","authors":"Faiza Rezwan, Tazeen Fatima, Farheen Ali, Muhammad Nadeem, Nawal Salahuddin","doi":"10.29271/jcpsp.2025.01.100","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.100","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency of multidrug-resistant (MDR) bacterial isolates in respiratory specimens obtained from ventilated patients admitted to critical care units at the National Institute of Cardiovascular Diseases (NICVD), along with COVID-19-positive cases.</p><p><strong>Study design: </strong>An observational study. Place and Duration of the Study: National Institute of Cardiovascular Diseases, between November 2021 and March 2022.</p><p><strong>Methodology: </strong>Tracheal aspirate and bronchoalveolar lavage (BAL) samples received for culture and sensitivity were obtained from the critical and surgical intensive care units during the specified period. The prevalence of MDR organisms was compared between gram-negative and gram-positive bacteria using the chi-square test to determine any statistical significant differences in their occurrence.</p><p><strong>Results: </strong>Throughout the study duration, 357 patients were admitted to critical care units, yielding 662 samples of tracheal aspirate and BAL. Among these samples, 229 bacterial isolates were identified, comprising 171 gram-negative rods (GNR) and 58 gram-positive cocci (GPC). The overall prevalence of MDR was determined to be 22% in GNR and 38% in GPC. Additionally, the prevalence of MDR among COVID-19 patients was observed to be approximately 11%.</p><p><strong>Conclusion: </strong>There was a notable frequency of MDR bacterial isolates in ventilated patients, particularly among GPC strains. Furthermore, the identified prevalence of MDR bacterial isolates in COVID-19 patients underscores the imperative for vigilant monitoring and intervention to address antibiotic resistance in this susceptible cohort.</p><p><strong>Key words: </strong>Ventilator-associated pneumonia, Bronchoalveolar lavage, Multidrug-resistant, Gram-negative rods, Gram-positive cocci, Coronavirus disease, Tracheal aspirate.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"100-105"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019057","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":"Serum Thyroglobulin as a Marker for Differential Diagnosis of Hyperthyroidism.","authors":"Fatimah Javaid Qureshi, Muhammad Anwar, Muhammad Qaiser Alam Khan, Muhammad Younas, Zaigham Salim Dar, Sajida Shaheen","doi":"10.29271/jcpsp.2025.01.39","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.39","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the role of serum thyroglobulin (TG) as a biochemical marker for differential diagnosis of common aetiologies of hyperthyroidism.</p><p><strong>Study design: </strong>Comparative cross-sectional study. Place and Duration of the Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan, from October 2023 to March 2024.</p><p><strong>Methodology: </strong>One hundred and forty-eight patients with clinical or biochemical hyperthyroidism were enrolled in the study. Samples were taken for serum thyroglobulin and evaluated for different causes of hyperthyroidism as demonstrated on the thyroid scan. Serum TG levels were measured using a chemiluminescence immunoassay and levels >42 ng/ml were considered elevated. Relationship between TG levels and different causes of hyperthyroidism was determined via independent samples non-parametric Kruskal-Wallis test.</p><p><strong>Results: </strong>The study found that 76.3% (n = 113) of patients had raised TG levels, with significant differences in median TG levels observed among the different hyperthyroidism aetiologies. Thyroiditis exhibited the highest median TG levels (202.5 ng/ml), followed by toxic adenoma (139 ng/ml) and toxic multinodular goitre (102 ng/ml), while Graves' disease had the lowest levels (34 ng/ml). Sensitivity of thyroglobulin to detect thyroid disease was 76% while specificity came out to be 100%. Positive predictive value (PPV) was 100% while negative predictive value (NPV) was 20.45%.</p><p><strong>Conclusion: </strong>Serum TG levels vary markedly among different aetiologies of hyperthyroidism with the highest levels in thyroiditis and the lowest in Graves' disease.</p><p><strong>Key words: </strong>Thyroglobulin, Hyperthyroidism, Graves' disease, Thyroiditis.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"39-43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017739","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":"Sweet Syndrome: A Retrospective Analysis of 21 Patients.","authors":"Yun Wang, Quansheng Lu, Pengfei Pan, Ran Fu, Guan Jiang","doi":"10.29271/jcpsp.2025.01.128","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.128","url":null,"abstract":"<p><p>Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare condition characterised by fever, leucocytosis, and painful skin lesions. This retrospective study analysed 21 patients with Sweet syndrome treated at the Affiliated Hospital of Xuzhou Medical University from January 2015 to June 2022. The study aimed to investigate the aetiology, clinicopathological features, and treatment outcomes. The majority of patients were female, with a median age of 54 years. Upper respiratory tract infection was identified as a common predisposing factor. Histopathological examination revealed neutrophilic infiltration without leucocytoclastic vasculitis. Treatment with glucocorticoids and glycyrrhizin was effective in managing the condition. Key Words: Sweet syndrome, Clinical analysis, Treatment, Glucocorticoids.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"128-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018612","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":"Embracing New Horizons in Medical Research.","authors":"Muhammad Shoaib Shafi","doi":"10.29271/jcpsp.2025.01.01","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.01","url":null,"abstract":"","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018954","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":"Ethics in Surgical Practice and Research.","authors":"Tanwir Khaliq","doi":"10.29271/jcpsp.2025.01.02","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.02","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"2-4"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019038","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":"Lumbar Erector Spinae Plane Block Provides Effective Postoperative Analgesia in Hip Fracture Surgery.","authors":"Onur Balaban, Ali Eman, Onur Palabiyik, Alauddin Kochai","doi":"10.29271/jcpsp.2025.01.05","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.05","url":null,"abstract":"<p><strong>Objective: </strong>To compare the postoperative analgesic effectiveness of ultrasound-guided lumbar erector spinae plane (LESP) block with lumbar plexus block (LPB) in patients operated for proximal femur fractures.</p><p><strong>Study design: </strong>A randomised controlled trial. Place and Duration of the Study: Sakarya Training and Research Hospital Operation Theatre, Sakarya, Turkiye, between January and June 2023.</p><p><strong>Methodology: </strong>Patients undergoing proximal femur fracture surgery were randomised to receive either an LESP block or an LPB block. The primary outcome was 24 hour opioid consumption, which was given via a standard patient-controlled analgesia protocol. The secondary outcome was postoperative pain scores (numerical rating scale between 0 and 10) at the 30th minute, 2nd, 6th, 12th, and 24th hour time points. Mann-Whitney U test was used to compare the primary and secondary outcomes.</p><p><strong>Results: </strong>A total of 64 patients were randomised, and 53 were analysed (25 patients in the LESP group and 28 patients in the LPB group). Demographic data were comparable between the groups. Mean NRS pain scores in 30th minute, 2nd, 6th, 12th, and 24th hours were 0.7 ± 1.3, 1.2 ± 1.8, 2.2 ± 2.3, 1.8 ± 1.9, and 1.9 ± 2.0 in the LESP group and 0.5 ± 1.0, 1.1 ± 1.8, 1.6 ± 1.9, 1.9 ± 1.9, and 1.6 ± 1.7 in the LPB group, respectively without significant difference. No significant differences were observed in fentanyl consumption between the LESP group (183.6 ± 171.7µg) and LPB group (131.1 ± 113.3µg, p = 0.415).</p><p><strong>Conclusion: </strong>Single injection LESP block provided satisfactory postoperative analgesia and comparable opioid consumption without a major complication. Therefore, the LESP block is an effective method for hip fracture surgery as a strong alternative to the LPB.</p><p><strong>Key words: </strong>Lumbar erector spinae plane block, Lumbar plexus block, Ultrasound-guided, Hip surgery, Femur fracture, Postoperative analgesia.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019082","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":"Peripheral Nerve Block Combined with Low-Dose General Anaesthesia in Elderly Patients Receiving Hip Arthroplasty.","authors":"Yulin Liu, Ying Zhu, Hong Fu","doi":"10.29271/jcpsp.2025.01.76","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.76","url":null,"abstract":"<p><p>The study assessed the effectiveness and safety of nerve block combined with low-dose general anaesthesia in elderly hip arthroplasty patients, conducted by a meta-analysis of RCTs. Six trials involving 403 patients were identified from databases such as Cochrane, MEDLINE, and PubMed. The results demonstrated a statistically significant difference in pain scores at postoperative 12hours (95% CI, -2.39 to -0.35, p = 0.008) and 24hours (95% CI, -1.86 to -0.50, p = 0.0007). Nerve block in combination with general anaesthesia holds a significant advantage over conventional general anaesthesia regarding perioperative opioid consumption (95% CI, -38.32 to -7.48, p = 0.004). This combined approach was superior in reducing the incidence of complications (95% CI, 0.11 to 0.55, p = 0.0007). However, between the two groups, there was no statistically significant difference in the 48hour pain score (95% CI, -2.58 to 0.62, p = 0.23). Essentially, this approach effectively reduces early post-surgical pain and it minimises anaesthetic use, whilst simultaneously lowering the risk of complications. Key Words: Nerve block, Elderly patients, Hip arthroplasty, Pain, Postoperative complication.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"76-82"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019121","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":"Tuberculosis of the Right Pubic Bone Complicated by Abscess of the Right Thin Femoral Muscle.","authors":"Bo Liu, Wendong Xie, Guifu Ma","doi":"10.29271/jcpsp.2025.01.131","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.131","url":null,"abstract":"<p><p>Null.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"131-132"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018972","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-Microbial Synergy: Mapping Microbiological Profiles to Clinical Attributes in Skin and Soft Tissue Infections.","authors":"Faiza Zeeshan, Asma Naeem, Fakhar Uddin, Bahram Khan Khoso, Binish Arif Sultan","doi":"10.29271/jcpsp.2025.01.49","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.49","url":null,"abstract":"<p><strong>Objective: </strong>To determine the clinical microbial synergy in skin and soft tissue infections (SSTIs) based on bacterial groups and explore the likelihood ratios of clinical parameters.</p><p><strong>Study design: </strong>Descriptive cross-sectional study. Place and Duration of the Study: The study was conducted at the Department of Microbiology, University of Karachi in collaboration with Jinnah Postgraduate Medical Centre, and Jinnah Sindh Medical University, Karachi, Pakistan, from June 2023 to May 2024.</p><p><strong>Methodology: </strong>A total of 304 pus samples from clinically diagnosed cases of SSTIs were included in the study and were processed for microbiological work-up. Isolates were cultured on blood and MacCokney's agar media. Staphylococcal species were identified via the Rapid-ID staph plus system. Continuous data was represented as mean and standard deviation and categorical data were expressed as frequencies (percentages) and were further analysed by using the Chi-square test and multinomial regression model.</p><p><strong>Results: </strong>The study revealed substantial associations between bacterial types and factors such as clinical unit, ethnicity, skin-barrier disruptions, infection site, and wound classification (p-value <0.05) in SSTIs. Metabolic and endocrine disorders increased the odds ratio of gram-negative rod infections (OR = 3.25). Accidents and trauma were associated with higher odds ratio of gram-positive cocci infections (OR = 3.288). Bacterial types varied across wound classes, with gram-positive cocci more common in classes I, II, and III (OR = 3.29, 2.00).</p><p><strong>Conclusion: </strong>This study identifies key predictors of bacterial aetiology in skin SSTIs, revealing increased associations between gram-negative rods and metabolic and endocrine disorders, gram-positive cocci and trauma-related SSTIs, and gram-negative rods in surgical site infections.</p><p><strong>Key words: </strong>Bacterial infections, Infection control, Soft tissue infections, Surgical site infections.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"49-54"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019033","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":"Influence of the Type of Bulk-Fill, Resin-Based Composite on Internal Adaptation in Class V Restorations.","authors":"Qianqian Gao, Tao Huang, Anna Wang, Qiong Sun, Fuhua Zhang, Lei Zhang","doi":"10.29271/jcpsp.2025.01.34","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.34","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of bulk-fill, resin-based composite types (high or low viscosity) on the internal adaptation of Class V restorations.</p><p><strong>Study design: </strong>Experimental study. Place and Duration of the Study: Hefei Stomatological Hospital, Hefei, China, from October 2022 to December 2023.</p><p><strong>Methodology: </strong>A total of 140 extracted human premolars were collected. Class V cavities were prepared on the buccal surface of each tooth, which was randomly divided into seven groups (n = 20). Cavities were restored by two low-viscosity and three high-viscosity bulk-fill resin-based composites or two conventional resin-based composites. All the samples were artificially aged. The percentage of debonding formation (D%) was calculated at baseline and 6 months later using optical coherence tomography (OCT). The OCT data were statistically analysed using one-way ANOVA, and the effects of composite type and artificial ageing were analysed via two-way ANOVA.</p><p><strong>Results: </strong>For Class V restorations, two low-viscosity bulk-fill resin-based composites generated significantly lower D% (p <0.05). Two-way ANOVA revealed that both composite type and artificial ageing significantly influenced internal adaptation (p <0.05).</p><p><strong>Conclusion: </strong>The low-viscosity bulk-fill resin composites demonstrated better internal adaptation both before and after artificial ageing.</p><p><strong>Key words: </strong>Bulk-fill resin composite, Debonding formation, Artificial ageing, Optical coherence tomography, Class V.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"34-38"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019075","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}