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

{"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":"Effect of Intravenous Paracetamol on Postoperative Recovery in Children Undergoing Hypospadias Repair under General Anaesthesia with Caudal Block: A Randomised Controlled Trial.","authors":"Muhammad Saad Yousuf, Ayesha Saleem, Abdul Monem, Zafar Nazir, Fauzia Anis Khan","doi":"10.29271/jcpsp.2025.01.11","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.11","url":null,"abstract":"<p><strong>Objective: </strong>To explore the impact of perioperative intravenous (IV) paracetamol, administered with caudal ropivacaine on the quality of postoperative recovery in children undergoing hypospadias repair.</p><p><strong>Study design: </strong>Double-blinded randomised controlled trial. Place and Duration of the Study: The operating room, post-anaesthesia care unit (PACU), and paediatric surgical ward at the Aga Khan University Hospital, from 31st January 2019 to 1st May 2022.</p><p><strong>Methodology: </strong>Children aged 3-10 years undergoing hypospadias repair were randomly divided into two groups. Group P was administered IV paracetamol 15 mg/kg an hour before the completion of the repair procedure. Group C received a placebo instead of paracetamol. Modified Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) was measured at 15 and 30 minutes, and at 1, 2, 4, and 6 hours postoperatively. The sedation score was documented for four hours postoperatively.</p><p><strong>Results: </strong>Out of total 59 children included in the analysis, 55% (n = 16) in the Group P and 45% (n = 13) in the Group C needed additional analgesia within the first six hours post-procedure. No significant variations were observed between the groups' CHEOPS scores and sedation levels.</p><p><strong>Conclusion: </strong>The addition of perioperative intravenous paracetamol 15 mg/kg in combination with 0.25% ropivacaine through the caudal route, along with general anaesthesia, did not significantly affect the quality of postoperative recovery in children measured by pain score and sedation.</p><p><strong>Key words: </strong>Intravenous paracetamol, Caudal analgesia, Ropivacaine, Paediatric patients.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"11-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018951","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":"Evaluation of Carbohydrate-Containing Fluid Preloading in Pregnant Women Using the Obstetric Quality of Recovery Scale after Caesarean Section.","authors":"Ozlem Dulger, Betul Basaran","doi":"10.29271/jcpsp.2025.01.17","DOIUrl":"https://doi.org/10.29271/jcpsp.2025.01.17","url":null,"abstract":"<p><strong>Objective: </strong>To test the short and long-term effects of consuming carbohydrate-rich beverages on patient-centred outcomes after caesarean delivery under spinal anaesthesia.</p><p><strong>Study design: </strong>A prospective randomised controlled study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Karaman Training and Research Hospital, Karaman, Turkiye, between May 2023 and February 2024.</p><p><strong>Methodology: </strong>A total of one hundred parturients were randomly assigned to two groups. Fifty parturients were in the control group (Group C) and 50 in the oral carbohydrate preloading group (Group OCH). Group OCH were given carbohydrate-rich fluids, while those in Group C received distilled water before undergoing elective caesarean surgery. The primary outcome of this study was to evaluate the Obstetric Quality of Recovery-10 scores (ObsQoR-10) at the postoperative 24th hour. Secondary outcomes were ObsQoR-10 scores on the postoperative 3rd and 7th day, postoperative pain scores, VAS scores, opioid consumption, and sensation of breast fullness. Welch's t-test and mixed-effect models were employed to analyse the outcomes.</p><p><strong>Results: </strong>The total recovery scores of both groups at the 24th hour, 3rd day, and 7th day were similar (Group C: 80.08 ± 15.58, Group OCH: 80.18 ± 14.6; Group C: 93.98 ± 7.45, Group OCH: 94.12 ± 8.86; Group C: 97.2 ± 5.16, and Group OCH: 98.16 ± 3.18, respectively). The sensation of breast fullness was significantly higher in the Group OCH (p <0.05). No difference was recorded between the groups regarding postoperative tramadol consumption, VAS scores, and the presence of postdural puncture headache (p >0.05).</p><p><strong>Conclusion: </strong>Although carbohydrate-rich beverages did not affect the ObsQoR-10 score, they may have a notable influence on the increase of breast fullness and tenderness, which promotes breastfeeding among postoperative mothers.</p><p><strong>Key words: </strong>Carbohydrate-containing fluid, Caesarean section, ObsQoR-10 scale, Postpartum recovery, Spinal anaesthesia.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"35 1","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019042","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 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":"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}