Objective: To assess the Clustered Differentiation 10 (CD10) expression in Urothelial carcinoma and to ascertain how its expression relates to grade and stage. Method: Descriptive cross sectional research was carried out over a period of six months in Pathology Department on eighty five cases of bladder carcinoma from transurethral resection of bladder (TURBT) specimens diagnosed on Hematoxylin-eosin (H & E) stained sections irrespective of patient's age and gender were included in the study. These were stained for CD10 by Immunohistochemical technique. Results: Sixty seven (78.8%) urothelial carcinomas showed positive CD10 staining while 18 cases (21.17%) demonstrated negative expression. In 67 positive cases, 42 high grade tumors had 2+ expression while 13 grade had 1+ staining .All low-grade tumors(12) displayed 1+ score. Sixteen tumorsin pT1, 21 tumorsin pT2 and 3 tumors in pT3 stage displayed 2+ score. Nineteen tumors in pT1 while 4 tumors in pT2 had 1+ score. Conclusion: Our findings indicate that CD10 expression is greater in high grade and invasive urothelial carcinomas and is associated with progression of bladder carcinomas.
{"title":"Immunohistochemical Expression of Clustered Differentiation 10 (CD10) Across Various Grade & Stage of Urinary BladderCarcinoma","authors":"Sidra Shoukat, Uzma Nabi, Atiya Begum, Afia Sarwar, Sara Sadiq, Fakhar Irfan","doi":"10.51273/esc23.2519219","DOIUrl":"https://doi.org/10.51273/esc23.2519219","url":null,"abstract":"Objective: To assess the Clustered Differentiation 10 (CD10) expression in Urothelial carcinoma and to ascertain how its expression relates to grade and stage. Method: Descriptive cross sectional research was carried out over a period of six months in Pathology Department on eighty five cases of bladder carcinoma from transurethral resection of bladder (TURBT) specimens diagnosed on Hematoxylin-eosin (H & E) stained sections irrespective of patient's age and gender were included in the study. These were stained for CD10 by Immunohistochemical technique. Results: Sixty seven (78.8%) urothelial carcinomas showed positive CD10 staining while 18 cases (21.17%) demonstrated negative expression. In 67 positive cases, 42 high grade tumors had 2+ expression while 13 grade had 1+ staining .All low-grade tumors(12) displayed 1+ score. Sixteen tumorsin pT1, 21 tumorsin pT2 and 3 tumors in pT3 stage displayed 2+ score. Nineteen tumors in pT1 while 4 tumors in pT2 had 1+ score. Conclusion: Our findings indicate that CD10 expression is greater in high grade and invasive urothelial carcinomas and is associated with progression of bladder carcinomas.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969204","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}
Objective: To assess the prevalence of work-related hazards faced by Pathologists and residents in the Pathology laboratory in Pakistan. Method: This cross-sectional study was conducted over a period of one month from January 2023 to February 2023. The research questionnaire was shared online amongst the Pathologists and Pathology residents. The collected data was analyzed using SPSS version 28. The qualitative data was described in terms of percentages or frequencies and analyzed using the Chi-square test. AP-value < 0.05 was considered statistically significant. Results: Out of 172 participants, the majority (74.5%) were females. 51.6% of the participants had 31 to 45 hours working, with 26.7% spending 2-4 hours daily on the microscope. Musculoskeletal disorders were seen in 93.2% of the study population followed by visual strain (90.6%) and anxiety and stress in 90.1%. 35.4% reported that the pain was severe enough to take off from work, which involved a greater percentage of females(38%) than males(26%). Males were found to exercise more as compared to females(p-value= 0.044). A significant finding in our study was that psychological disturbances were experienced more in females as compared to males (p-value=0.00,0.00 & 0.00). Conclusion: This study highlights the importance of workplace-based hazards faced by pathologists. Postural support, monitoring work hours, and taking small stretch breaks can play an important part in their professional well-being
{"title":"Occupational Health Risks among Pathologists and Pathology Trainees: An Analysis of Prevalence and Factors","authors":"Afia Sarwar, Atiya Begum, Kanwal Cheema, Majid Rauf","doi":"10.51273/esc23.2519212","DOIUrl":"https://doi.org/10.51273/esc23.2519212","url":null,"abstract":"Objective: To assess the prevalence of work-related hazards faced by Pathologists and residents in the Pathology laboratory in Pakistan. Method: This cross-sectional study was conducted over a period of one month from January 2023 to February 2023. The research questionnaire was shared online amongst the Pathologists and Pathology residents. The collected data was analyzed using SPSS version 28. The qualitative data was described in terms of percentages or frequencies and analyzed using the Chi-square test. AP-value < 0.05 was considered statistically significant. Results: Out of 172 participants, the majority (74.5%) were females. 51.6% of the participants had 31 to 45 hours working, with 26.7% spending 2-4 hours daily on the microscope. Musculoskeletal disorders were seen in 93.2% of the study population followed by visual strain (90.6%) and anxiety and stress in 90.1%. 35.4% reported that the pain was severe enough to take off from work, which involved a greater percentage of females(38%) than males(26%). Males were found to exercise more as compared to females(p-value= 0.044). A significant finding in our study was that psychological disturbances were experienced more in females as compared to males (p-value=0.00,0.00 & 0.00). Conclusion: This study highlights the importance of workplace-based hazards faced by pathologists. Postural support, monitoring work hours, and taking small stretch breaks can play an important part in their professional well-being","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969210","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}
Objective: The purpose of study was to determine the frequent pathogens in tracheal secretions and sputum specimens along with the antimicrobial susceptibility pattern. Methods: This descriptive study was conducted in the department of Pathology and Microbiology, Farooq Hospital Lahore, Pakistan and data included was taken from 1st August 2022 to 31st December 2022. The specimens were inoculated on blood agar and MacConkey agar and incubated for 24 hours at 37 0 C. The Kirby Bauer disc diffusion method was employed to find out the antimicrobial susceptibility pattern. The SPSS was used to assess the data. Results: From the total 102 positive culture growths, Klebsiella species (35.2%) was frequently isolated followed by Pseudomonas species (25.4%), Acinetobacter species (23.5%), Escherichia coli (9.8%), Staphylococcus aureus(3.9%), Citrobacter species (0.9%), and Proteus species (0.9%). The doxycycline and linezolid were completely effective (100%) against the gram positive cocci. The Klebsiella species, Pseudomonas species, Acinetobacter species, and Escherichia coli, showed maximum sensitivity to tigecycline. Conclusion: The most commonly isolated gram negative rod was Klebsiella species and tigecycline was found to be the most effective antibiotic against it. Multidrug resistance among respiratory pathogens is the major issue so it is necessary to administer antibiotic therapy in a limited and objective manner
{"title":"Bacterial Isolates and their Antimicrobial Susceptibility Pattern from Tracheal Secretions and Sputum of Admitted and OutdoorPatients","authors":"Omair Farooq, Nadia Wali, Zainab Yousaf, Shumaila Rashid, Asim Mumtaz, Maleeha Aslam","doi":"10.51273/esc23.251923","DOIUrl":"https://doi.org/10.51273/esc23.251923","url":null,"abstract":"Objective: The purpose of study was to determine the frequent pathogens in tracheal secretions and sputum specimens along with the antimicrobial susceptibility pattern. Methods: This descriptive study was conducted in the department of Pathology and Microbiology, Farooq Hospital Lahore, Pakistan and data included was taken from 1st August 2022 to 31st December 2022. The specimens were inoculated on blood agar and MacConkey agar and incubated for 24 hours at 37 0 C. The Kirby Bauer disc diffusion method was employed to find out the antimicrobial susceptibility pattern. The SPSS was used to assess the data. Results: From the total 102 positive culture growths, Klebsiella species (35.2%) was frequently isolated followed by Pseudomonas species (25.4%), Acinetobacter species (23.5%), Escherichia coli (9.8%), Staphylococcus aureus(3.9%), Citrobacter species (0.9%), and Proteus species (0.9%). The doxycycline and linezolid were completely effective (100%) against the gram positive cocci. The Klebsiella species, Pseudomonas species, Acinetobacter species, and Escherichia coli, showed maximum sensitivity to tigecycline. Conclusion: The most commonly isolated gram negative rod was Klebsiella species and tigecycline was found to be the most effective antibiotic against it. Multidrug resistance among respiratory pathogens is the major issue so it is necessary to administer antibiotic therapy in a limited and objective manner","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969368","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}
Omair Farooq, Waqas Sami, Alia Waheed, Asim Mumtaz, Zainab Yousaf, Eazaz Ali Khan, Atiqa Arshad
Objective: To compare the clinical, hematological and biochemical characteristics of patients suffering from delta and non-delta variants of COVID-19. Method: This cross-sectional study was conducted at Farooq Hospital Westwood Lahore during 1st March 2022 to 31st August 2022. After obtaining informed written consent, nasopharyngeal swabs and 5 ml of blood samples in both EDTA and clotted vacutainers of eighty two infected patients with COVID-19, who were admitted in COVID-19 unit, were collected. The viral nucleic acid was isolated from nasopharyngeal swabs by using a Qiagen nucleic acid extraction kit. RT-PCR was performed to detect the delta variant in COVID-19 infected patients by using SARS-CoV-2 Variant B.1.617 identification kit. Further hematological and biochemical parameters were performed. Results: We did a comparative analysis of clinical and laboratory characteristic of delta and non-delta COVID19 patients admitted in Farooq Hospital Westwood, confirmed by RT-PCR and found that patients presented with delta variant had more severe disease with significantly more cough, fever, shortness of breath and lower SpO2 at the presentation. The hematological and biochemical markers showed more lymphopenia, greater CRP,Interleukin 6,LDHand ferritin.Hospitalstay of delta variants ofCOVID-19 patients had longer duration as compared to the non-delta COVID-19 patients. Conclusion: Delta COVID-19 had more severe disease with more dyspnea, hypoxia, hematological and biochemical parameters abnormalities compared to the non-delta COVID-19 patients. Patients suffering from delta variant of COVID-19 had greater length of hospital stay as compared to the non-delta variant of COVID-19 with more oxygen requirement and more mortality rate.
{"title":"Comparison of Clinical, Hematological and Biochemical Characteristics of Patients Suffering from Delta and Non-Delta Variant of COVID-19","authors":"Omair Farooq, Waqas Sami, Alia Waheed, Asim Mumtaz, Zainab Yousaf, Eazaz Ali Khan, Atiqa Arshad","doi":"10.51273/esc23.251921","DOIUrl":"https://doi.org/10.51273/esc23.251921","url":null,"abstract":"Objective: To compare the clinical, hematological and biochemical characteristics of patients suffering from delta and non-delta variants of COVID-19. Method: This cross-sectional study was conducted at Farooq Hospital Westwood Lahore during 1st March 2022 to 31st August 2022. After obtaining informed written consent, nasopharyngeal swabs and 5 ml of blood samples in both EDTA and clotted vacutainers of eighty two infected patients with COVID-19, who were admitted in COVID-19 unit, were collected. The viral nucleic acid was isolated from nasopharyngeal swabs by using a Qiagen nucleic acid extraction kit. RT-PCR was performed to detect the delta variant in COVID-19 infected patients by using SARS-CoV-2 Variant B.1.617 identification kit. Further hematological and biochemical parameters were performed. Results: We did a comparative analysis of clinical and laboratory characteristic of delta and non-delta COVID19 patients admitted in Farooq Hospital Westwood, confirmed by RT-PCR and found that patients presented with delta variant had more severe disease with significantly more cough, fever, shortness of breath and lower SpO2 at the presentation. The hematological and biochemical markers showed more lymphopenia, greater CRP,Interleukin 6,LDHand ferritin.Hospitalstay of delta variants ofCOVID-19 patients had longer duration as compared to the non-delta COVID-19 patients. Conclusion: Delta COVID-19 had more severe disease with more dyspnea, hypoxia, hematological and biochemical parameters abnormalities compared to the non-delta COVID-19 patients. Patients suffering from delta variant of COVID-19 had greater length of hospital stay as compared to the non-delta variant of COVID-19 with more oxygen requirement and more mortality rate.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"102 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969373","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}
Misbah ul-Qamar, Shumaela Kanwal, Fareha Saleem, Sana Qanbar Abbasi, Yasmeen Ahmed
Objective: To evaluate if the elevated levels of Anti-Mullerian hormone (AMH) could serve as an indicator of polycystic ovarian syndrome (PCOS) in patients presenting with infertility. Method: The present study was conducted at Institute of Molecular Biology and Biotechnology, The University ofLahore andAustralianConceptInfertilityMedicalCenter(ACIMC),Lahore. It was a case control study. Atotal of 101 females aged between 20-40 years presenting with infertility were included in this study. Among study participants, 51 infertile females had PCOS and 50 were non-PCOS infertile subjects. After taking informed consent, medical history and anthropometric indices were recorded on standardized proforma.Transvaginal ultrasound was done to assess ovarian morphology. Serum AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH) and prolactin levels were measured by commercially available ELISAkits. Serum AMH levels were measured in 10 healthy, fertile females having normal menstrual cycle as normal reference values in our population. Results: Mean AMH levels were significantly higher (9.9±1.1ng/ml) in females with polycystic ovarian syndrome as compared to subjects without this syndrome (1.0± 0.3ng/ml). Mean FSH levels were significantly lower in females with PCOS (p value 0.001) but LH: FSH ratio, serum luteinizing hormone and prolactin level were not significantly different in two groups. Conclusion: The study provides evidence that raised serum levels of AMH are associated with the presence of PCOS and therefore can serve as useful marker in diagnosis of PCOS
{"title":"Diagnostic Role of Anti-Mullerian hormone in Polycystic Ovarian Syndrome","authors":"Misbah ul-Qamar, Shumaela Kanwal, Fareha Saleem, Sana Qanbar Abbasi, Yasmeen Ahmed","doi":"10.51273/esc23.251927","DOIUrl":"https://doi.org/10.51273/esc23.251927","url":null,"abstract":"Objective: To evaluate if the elevated levels of Anti-Mullerian hormone (AMH) could serve as an indicator of polycystic ovarian syndrome (PCOS) in patients presenting with infertility. Method: The present study was conducted at Institute of Molecular Biology and Biotechnology, The University ofLahore andAustralianConceptInfertilityMedicalCenter(ACIMC),Lahore. It was a case control study. Atotal of 101 females aged between 20-40 years presenting with infertility were included in this study. Among study participants, 51 infertile females had PCOS and 50 were non-PCOS infertile subjects. After taking informed consent, medical history and anthropometric indices were recorded on standardized proforma.Transvaginal ultrasound was done to assess ovarian morphology. Serum AMH, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH) and prolactin levels were measured by commercially available ELISAkits. Serum AMH levels were measured in 10 healthy, fertile females having normal menstrual cycle as normal reference values in our population. Results: Mean AMH levels were significantly higher (9.9±1.1ng/ml) in females with polycystic ovarian syndrome as compared to subjects without this syndrome (1.0± 0.3ng/ml). Mean FSH levels were significantly lower in females with PCOS (p value 0.001) but LH: FSH ratio, serum luteinizing hormone and prolactin level were not significantly different in two groups. Conclusion: The study provides evidence that raised serum levels of AMH are associated with the presence of PCOS and therefore can serve as useful marker in diagnosis of PCOS","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"169 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969376","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}
Mudessarat Rafaq, Noman Ali Ghazanfar, Obaid Ur Rehman, Fayyaz Ur Rehman Haider, Shabbar Hussain Changazi, Muhammad Shahzad Anwar
Objective: To assess its role in stone clearance along with ESWLin patients with upper ureteric stones. Method: This clinical trial was conducted from February 2018 to December 2021 at the Department of Urology, Services Hospital Lahore.. Atotal of 164 patients (82 in each group) of both sexes between the ages of 18 and 70 years with upper ureteric stone (6mm-15mm) were included in this study. These patients were randomly divided into two groups. Patients in group A received ESWL alone, while patients in group B received ESWL in combination with tamsulosin therapy. Follow-up visits with CT KUB Plain were planned 4 weeks postoperatively to assess stone clearance Results: The mean age of patients was 44.01±10.88 years. The study included 124 (75.6%) male and 40 (24.4%) female patients. The mean size of stones was 9.59±2.72 mm. Both the groups were comparable in terms of mean age (p=0.539), mean stone size (p=0.936), age groups (p=0.507), stone size groups (p=0.817), and gender distribution (p=0.631). The stone clearance rate was significantly higher in patients treated with ESWLin combination with tasmsulosin therapy (92.7% vs. 65.9%; p=0.003) compared to ESWLalone. Conclusion: The clearance rate was significantly higher in patients treated with ESWL in combination with tasmsulosin therapy compared to ESWLalone.
目的:探讨ESWLin在输尿管上段结石患者结石清除中的作用。方法:本临床试验于2018年2月至2021年12月在拉合尔服务医院泌尿外科进行。本研究共纳入18 ~ 70岁输尿管上段结石(6mm-15mm)患者164例(每组82例)。这些患者被随机分为两组。A组患者单独进行ESWL治疗，B组患者联合坦索罗辛治疗。术后4周行CT KUB平扫随访，评估结石清除情况。结果:患者平均年龄44.01±10.88岁。其中男性124例(75.6%)，女性40例(24.4%)。结石平均大小为9.59±2.72 mm。两组在平均年龄(p=0.539)、平均结石大小(p=0.936)、年龄组(p=0.507)、结石大小组(p=0.817)和性别分布(p=0.631)方面具有可比性。ESWLin联合tasmsulosin治疗的患者结石清除率明显更高(92.7% vs. 65.9%;p=0.003)。结论:ESWL联合tasmsulosin治疗的清除率明显高于ESWL单用。
{"title":"Stone Clearance in Patients with Upper Ureteric Stones Using Extracorporeal Shock Wave Lithotripsy Compared with Extracorporeal Shock Wave Lithotripsy Combined with Tamsulosin Therapy","authors":"Mudessarat Rafaq, Noman Ali Ghazanfar, Obaid Ur Rehman, Fayyaz Ur Rehman Haider, Shabbar Hussain Changazi, Muhammad Shahzad Anwar","doi":"10.51273/esc23.2519218","DOIUrl":"https://doi.org/10.51273/esc23.2519218","url":null,"abstract":"Objective: To assess its role in stone clearance along with ESWLin patients with upper ureteric stones. Method: This clinical trial was conducted from February 2018 to December 2021 at the Department of Urology, Services Hospital Lahore.. Atotal of 164 patients (82 in each group) of both sexes between the ages of 18 and 70 years with upper ureteric stone (6mm-15mm) were included in this study. These patients were randomly divided into two groups. Patients in group A received ESWL alone, while patients in group B received ESWL in combination with tamsulosin therapy. Follow-up visits with CT KUB Plain were planned 4 weeks postoperatively to assess stone clearance Results: The mean age of patients was 44.01±10.88 years. The study included 124 (75.6%) male and 40 (24.4%) female patients. The mean size of stones was 9.59±2.72 mm. Both the groups were comparable in terms of mean age (p=0.539), mean stone size (p=0.936), age groups (p=0.507), stone size groups (p=0.817), and gender distribution (p=0.631). The stone clearance rate was significantly higher in patients treated with ESWLin combination with tasmsulosin therapy (92.7% vs. 65.9%; p=0.003) compared to ESWLalone. Conclusion: The clearance rate was significantly higher in patients treated with ESWL in combination with tasmsulosin therapy compared to ESWLalone.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969203","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}
Dr Muhammad Sajid, Nousheen Fatima, Mir Nousharwan, Ameer Ahmad
Objective: To evaluate Trends of cortisol level and its relation with Respiratory distress syndrome and Mortality in premature babies Materials & Methods: A descriptive cross sectional study was conducted in Neonatal unit of pediatric medicine 1 of Bahawalvictoria hospital Bahawalpur from Feb 2021 to June 2021.Premature babies (less than 36 weeks gestation by ballard scoring )admitted in Preterm ward on day 1 were enrolled after informed consent and ruling out exclusion criteria (More than 24 hour old , Who have received antenatal steroids for lung maturation, Received any treatment before admission in any other hospital, Patient having Any obvious anomaly ).Day 1 sample sent for CRP and cortisol. Data recorded regarding weight, gestational age (ballard scoring), septic risk factors. These patients were followed for development of RDS ( on X ray at 24 hour of life). Outcome was documented as expiry, discharged or LAMA. Data analyzed in SPSS 20. Results:40 patients were enrolled as per inclusion criteria. 27 (67.5 % ) were male and 13 (32.5 %) were female. Gestational age 3 (7.5 %) had less than 28 weeks, 29-30 weeks were 6 (15 %), 31-34 weeks were 31 (77.5 %). Weight less than 1.5 kg were 23 (57.5%), 1.5 to2 kg were 15 (37.5 %), 2.1-2.5 kg were 2 (5%). Cortisol level low in 4 (10 %), normal in 6 (15 %), high in 30 (75 %).22 (55 %) discharged, 13 (32 %) expired, and 5 (12.5 %) got LAMA. Cortisol level as compared to outcome has p value 0.002. Tweleve (30 %) had RDS. Twenty two (55 %) had evidence of sepsis. 18 (45 %) had CRP more than 6. Cortisol level as compared to RDS presence has P value 0.057 and with sepsis has P value 0.007. Mean cortisol in discharged patients were 19.8, expired 14.2 and LAMA has 22.7. Mean cortisol in RDS patients were 18.3 and RDS absent had 18.3 also. Mean cortisol in Sepsis positive patients were 18.6 and sepsis absent were 18.0 Conclusion: Mean cortisol has no significant difference in discharged and expired patients.
{"title":"Association of Serum Cortisol Levels with Respiratory Distress Syndrome and Mortality in Premature Babies","authors":"Dr Muhammad Sajid, Nousheen Fatima, Mir Nousharwan, Ameer Ahmad","doi":"10.51273/esc23.251919","DOIUrl":"https://doi.org/10.51273/esc23.251919","url":null,"abstract":"Objective: To evaluate Trends of cortisol level and its relation with Respiratory distress syndrome and Mortality in premature babies Materials & Methods: A descriptive cross sectional study was conducted in Neonatal unit of pediatric medicine 1 of Bahawalvictoria hospital Bahawalpur from Feb 2021 to June 2021.Premature babies (less than 36 weeks gestation by ballard scoring )admitted in Preterm ward on day 1 were enrolled after informed consent and ruling out exclusion criteria (More than 24 hour old , Who have received antenatal steroids for lung maturation, Received any treatment before admission in any other hospital, Patient having Any obvious anomaly ).Day 1 sample sent for CRP and cortisol. Data recorded regarding weight, gestational age (ballard scoring), septic risk factors. These patients were followed for development of RDS ( on X ray at 24 hour of life). Outcome was documented as expiry, discharged or LAMA. Data analyzed in SPSS 20. Results:40 patients were enrolled as per inclusion criteria. 27 (67.5 % ) were male and 13 (32.5 %) were female. Gestational age 3 (7.5 %) had less than 28 weeks, 29-30 weeks were 6 (15 %), 31-34 weeks were 31 (77.5 %). Weight less than 1.5 kg were 23 (57.5%), 1.5 to2 kg were 15 (37.5 %), 2.1-2.5 kg were 2 (5%). Cortisol level low in 4 (10 %), normal in 6 (15 %), high in 30 (75 %).22 (55 %) discharged, 13 (32 %) expired, and 5 (12.5 %) got LAMA. Cortisol level as compared to outcome has p value 0.002. Tweleve (30 %) had RDS. Twenty two (55 %) had evidence of sepsis. 18 (45 %) had CRP more than 6. Cortisol level as compared to RDS presence has P value 0.057 and with sepsis has P value 0.007. Mean cortisol in discharged patients were 19.8, expired 14.2 and LAMA has 22.7. Mean cortisol in RDS patients were 18.3 and RDS absent had 18.3 also. Mean cortisol in Sepsis positive patients were 18.6 and sepsis absent were 18.0 Conclusion: Mean cortisol has no significant difference in discharged and expired patients.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135288131","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}
Saba Saif, Rizwana Kitchlew, Spenta Kakalia, Bilal Azeem Butt
Objectives: To compare the characteristics of methotrexate-tolerant and intolerant patients having rheumatoid arthritis. To determine the association of methotrexate intolerance with the patient and disease-related factors. Method: This cross-sectional study was carried out at the rheumatology department of Combined Military Hospital Lahore from 31st April to 30th June 2022. It included 181 rheumatoid arthritis (RA) patients using methotrexate (MTX) for > 3 months. Patient demographic variables, disease duration and activity, and information regarding MTX intake were recorded. English methotrexate intolerance severity score (MISS) questionnaire was used to calculate MTX intolerance. Different variables were compared between methotrexate-tolerant and intolerant patients. Association of age, disease duration, and activity, MTX route/dose with MTX intolerance was determined. Results: The majority of patients were females 140(77%). The median disease duration was 6(1-40) years. MTX intolerance was found in 48(26.5%) of RA patients. Intolerant patients had a higher disease activity score (DAS 28>5.1 in 20.8 vs 3.8%; P = 0.002) and longer duration of MTX intake in months (23.5 vs 12; p=0.018) compared to tolerant patients. Additionally, MTX intolerance was associated with younger age, longer disease duration and higher MTX dose>10mg/wk (P=0.007, P=0.025, P=0.050). There was no significant difference between the two groups in gender, marital status, education, and use of other DMARDs or steroids. (P >0.05). Conclusion: There was a significant association between age, disease duration, and MTX dose with MTX intolerance. We also noted a significant association between disease activity and route of intake with MTX intolerance but this was lost when adjusted for multiple confounders.
目的:比较类风湿性关节炎甲氨蝶呤耐受和不耐受患者的特点。确定甲氨蝶呤不耐受与患者及疾病相关因素的关系。方法:横断面研究于2022年4月31日至6月30日在拉合尔联合军事医院风湿病科进行。该研究包括181例使用甲氨蝶呤(MTX)治疗的类风湿性关节炎(RA)患者;3个月。记录患者人口统计变量、疾病持续时间和活动量以及甲氨蝶呤摄入量信息。采用英文甲氨蝶呤不耐受严重程度评分(MISS)问卷计算甲氨蝶呤不耐受程度。比较甲氨蝶呤耐受和不耐受患者的不同变量。确定年龄、病程、活动、MTX途径/剂量与MTX不耐受的关系。结果:以女性140例(77%)为主。中位病程为6(1-40)年。48例(26.5%)RA患者发现MTX不耐受。不耐受患者的疾病活动评分较高(DAS 28>5.1, 20.8 vs 3.8%;P = 0.002)，服用甲氨蝶呤的时间更长(23.5 vs 12;P =0.018)。此外，MTX不耐受与年龄较小、病程较长和MTX剂量较高(10mg/周)相关(P=0.007, P=0.025, P=0.050)。两组患者在性别、婚姻状况、教育程度、其他dmard或类固醇的使用等方面无显著差异。(P在0.05)。结论:年龄、病程、甲氨蝶呤剂量与甲氨蝶呤不耐受之间存在显著相关性。我们还注意到MTX不耐受与疾病活动度和摄入途径之间的显著关联，但在对多个混杂因素进行调整后，这种关联就消失了。
{"title":"Comparison of Characteristics of Methotrexate Tolerant and Intolerant Patients Having Rheumatoid Arthritis","authors":"Saba Saif, Rizwana Kitchlew, Spenta Kakalia, Bilal Azeem Butt","doi":"10.51273/esc23.251918","DOIUrl":"https://doi.org/10.51273/esc23.251918","url":null,"abstract":"Objectives: To compare the characteristics of methotrexate-tolerant and intolerant patients having rheumatoid arthritis. To determine the association of methotrexate intolerance with the patient and disease-related factors. Method: This cross-sectional study was carried out at the rheumatology department of Combined Military Hospital Lahore from 31st April to 30th June 2022. It included 181 rheumatoid arthritis (RA) patients using methotrexate (MTX) for > 3 months. Patient demographic variables, disease duration and activity, and information regarding MTX intake were recorded. English methotrexate intolerance severity score (MISS) questionnaire was used to calculate MTX intolerance. Different variables were compared between methotrexate-tolerant and intolerant patients. Association of age, disease duration, and activity, MTX route/dose with MTX intolerance was determined. Results: The majority of patients were females 140(77%). The median disease duration was 6(1-40) years. MTX intolerance was found in 48(26.5%) of RA patients. Intolerant patients had a higher disease activity score (DAS 28>5.1 in 20.8 vs 3.8%; P = 0.002) and longer duration of MTX intake in months (23.5 vs 12; p=0.018) compared to tolerant patients. Additionally, MTX intolerance was associated with younger age, longer disease duration and higher MTX dose>10mg/wk (P=0.007, P=0.025, P=0.050). There was no significant difference between the two groups in gender, marital status, education, and use of other DMARDs or steroids. (P >0.05). Conclusion: There was a significant association between age, disease duration, and MTX dose with MTX intolerance. We also noted a significant association between disease activity and route of intake with MTX intolerance but this was lost when adjusted for multiple confounders.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135288126","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}
Dr Farhat, Dr Rana Khurram Aftab, Hira Sohail, Nimra Masood Baig, Ayaz Ali Samo, Zulfiqar Ali Laghari
Objective: To determine the correlation between visceral fat and body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and CVD risk factors in males and females of the Pakistani population. Methods Four hundred six (406) participants were enrolled in the study after taking ethical approval from the institute. The age of the participants was 30 to 65 years. A uniform survey and physical examination were given to each participant. We took anthropometric measurements (BMI, WC, WHR, WHtR, SBP, and DBP). Fasting blood sugar and the serum lipid profile (TC, TG, HDL-C, and LDL-C) were measured. Results: The participants with visceral fat ≥10% have increased levels of SBP, DBP, Cholesterol, LDL, TG, and FBS. A significant positive correlation between visceral fat was observed with Weight, BMI, WC, WHR, SBP, DBP, Cholesterol, TG, and FBS. Conclusion: CV risk increases with the increase in weight, BMI, WC, WHR, SBP, DBP, Cholesterol, TG, and FBS
{"title":"Correlation of Visceral Fat with Anthropometric Indices and cardiovascular disease Risk factors","authors":"Dr Farhat, Dr Rana Khurram Aftab, Hira Sohail, Nimra Masood Baig, Ayaz Ali Samo, Zulfiqar Ali Laghari","doi":"10.51273/esc23.251916","DOIUrl":"https://doi.org/10.51273/esc23.251916","url":null,"abstract":"Objective: To determine the correlation between visceral fat and body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and CVD risk factors in males and females of the Pakistani population. Methods Four hundred six (406) participants were enrolled in the study after taking ethical approval from the institute. The age of the participants was 30 to 65 years. A uniform survey and physical examination were given to each participant. We took anthropometric measurements (BMI, WC, WHR, WHtR, SBP, and DBP). Fasting blood sugar and the serum lipid profile (TC, TG, HDL-C, and LDL-C) were measured. Results: The participants with visceral fat ≥10% have increased levels of SBP, DBP, Cholesterol, LDL, TG, and FBS. A significant positive correlation between visceral fat was observed with Weight, BMI, WC, WHR, SBP, DBP, Cholesterol, TG, and FBS. Conclusion: CV risk increases with the increase in weight, BMI, WC, WHR, SBP, DBP, Cholesterol, TG, and FBS","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135288118","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}
Dr Muhammad Akhtar, Muhammad Tasneem Javed, Omer Iqbal Cheema, Shahzad Anver Qureshi, Saif ur-Rehman, Omar Anwar, Rana Dilawaiz Nadeem
Objective: The objective of this study was to evaluate the radiological and functional outcomes in of treatment of fracture distal tibial metaphysis fixed with pre-contoured anatomical locking compression plate using minimally invasive percutaneous plate osteosynthesis (MIPO) technique. Methods: This was a prospective study conducted at Department of Orthopedic Surgery, Services Hospital Lahore. Total of 58 closed distal tibial metaphyseal fractures (AO classification 43A) included in the study. All patients were operated using anatomical LCP with MIPO technique. The functional outcome was assessed by Tenny & Wiss criteria at 6 weekly intervals with final scoring at 24th week. Functional outcome was graded as excellent, good, fair and poor. Similarly, radiological outcome was also assessed at 6 week intervals using Hammer et al criteria and grade 3 labelled as union. Results: We observed excellent functional outcome in 48 patients (82.6%) and good outcome in 6(10.34%) at last follow-up. Radiological union was achieved in 100% (58) patients at 24th week. The average time of union was 16.5 weeks with a range of 12 to 23 weeks. Total 03 patients (5.17%) developed superficial wound infection which was successfully managed with antibiotic therapy and no surgical site deep infection reported. Conclusion: Results of this study advocate that treatment of distal tibial metaphyseal fractures with LCP by MIPPO technique is an effective modality resulting in low complication rate, high union rates and good functional outcome.
{"title":"Minimally Invasive Percutaneous Plate Osteosynthesis (MIPO) for Distal Tibial Metaphyseal Fracture: A Better Option","authors":"Dr Muhammad Akhtar, Muhammad Tasneem Javed, Omer Iqbal Cheema, Shahzad Anver Qureshi, Saif ur-Rehman, Omar Anwar, Rana Dilawaiz Nadeem","doi":"10.51273/esc23.251913","DOIUrl":"https://doi.org/10.51273/esc23.251913","url":null,"abstract":"Objective: The objective of this study was to evaluate the radiological and functional outcomes in of treatment of fracture distal tibial metaphysis fixed with pre-contoured anatomical locking compression plate using minimally invasive percutaneous plate osteosynthesis (MIPO) technique. Methods: This was a prospective study conducted at Department of Orthopedic Surgery, Services Hospital Lahore. Total of 58 closed distal tibial metaphyseal fractures (AO classification 43A) included in the study. All patients were operated using anatomical LCP with MIPO technique. The functional outcome was assessed by Tenny & Wiss criteria at 6 weekly intervals with final scoring at 24th week. Functional outcome was graded as excellent, good, fair and poor. Similarly, radiological outcome was also assessed at 6 week intervals using Hammer et al criteria and grade 3 labelled as union. Results: We observed excellent functional outcome in 48 patients (82.6%) and good outcome in 6(10.34%) at last follow-up. Radiological union was achieved in 100% (58) patients at 24th week. The average time of union was 16.5 weeks with a range of 12 to 23 weeks. Total 03 patients (5.17%) developed superficial wound infection which was successfully managed with antibiotic therapy and no surgical site deep infection reported. Conclusion: Results of this study advocate that treatment of distal tibial metaphyseal fractures with LCP by MIPPO technique is an effective modality resulting in low complication rate, high union rates and good functional outcome.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135288122","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}
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