Xiao Wang, Dan Zhang, Kang Li, Peng Guo, Zhi-Xiong Lei
Objective: To explore the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with targeted therapy for primary hepatocellular carcinoma (PHC).
Methods: This was a retrospective study. Retrospective selection of 150 PHC patients admitted to the Renmin Hospital, Hubei University of Medicine January 2019 and June 2021 were included. The patients were divided into the control group and the experimental group according to their treatment regimens. The control group received TACE treatment, while the experimental group received TACE combined with targeted therapy. We analyze the relevant data of two groups of patients and evaluate the clinical efficacy and safety of TACE combined with targeted therapy.
Results: The tumor remission rate and control rate in the control group were 41.89% and 75.68%, respectively, while those in the experimental group were 77.63% and 90.79%, with statistically significant differences (p<0.05). The 1-year and 3-year recurrence rates in the control group were 52.71% and 98.65%, respectively, while those in the experimental group were 39.47% and 61.84%, with statistically significant differences (p<0.05). After treatment, the AFP, VEGF, ALT, and AST in the experimental group were significantly reduced compared to the control group (p<0.05). During the treatment period, the incidence and severity of nausea, vomiting, and fever in the experimental group were significantly lower than those in the control group (p<0.05).
Conclusion: The clinical efficacy of TACE combined with targeted therapy for PHC is superior to that of TACE alone, with improved disease control rate, improved long-term survival rate, and good safety.
{"title":"Clinical Efficacy and Safety of transarterial chemoembolization Combined with Targeted Therapy for primary hepatocellular carcinoma.","authors":"Xiao Wang, Dan Zhang, Kang Li, Peng Guo, Zhi-Xiong Lei","doi":"10.12669/pjms.40.8.8982","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8982","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with targeted therapy for primary hepatocellular carcinoma (PHC).</p><p><strong>Methods: </strong>This was a retrospective study. Retrospective selection of 150 PHC patients admitted to the Renmin Hospital, Hubei University of Medicine January 2019 and June 2021 were included. The patients were divided into the control group and the experimental group according to their treatment regimens. The control group received TACE treatment, while the experimental group received TACE combined with targeted therapy. We analyze the relevant data of two groups of patients and evaluate the clinical efficacy and safety of TACE combined with targeted therapy.</p><p><strong>Results: </strong>The tumor remission rate and control rate in the control group were 41.89% and 75.68%, respectively, while those in the experimental group were 77.63% and 90.79%, with statistically significant differences (p<0.05). The 1-year and 3-year recurrence rates in the control group were 52.71% and 98.65%, respectively, while those in the experimental group were 39.47% and 61.84%, with statistically significant differences (p<0.05). After treatment, the AFP, VEGF, ALT, and AST in the experimental group were significantly reduced compared to the control group (p<0.05). During the treatment period, the incidence and severity of nausea, vomiting, and fever in the experimental group were significantly lower than those in the control group (p<0.05).</p><p><strong>Conclusion: </strong>The clinical efficacy of TACE combined with targeted therapy for PHC is superior to that of TACE alone, with improved disease control rate, improved long-term survival rate, and good safety.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To evaluate the effects of CT to improve HbA1C and ABI among the T2DM-associated PAD population.
Methods: A randomized, single-blinded, two-arm trial was conducted at the Department of Rehabilitation Sciences of Dr. Ziauddin Hospital in Karachi between July to September 2023. A total of 80 T2DM-associated PAD patients were included and randomly divided into Experimental Group (n=40) and Control Group (n=40), using the sealed envelope method. Experimental group patients received Concurrent Training (CT), whereas Control Group patients underwent Aerobic Training (AT) for 12 weeks. Both groups received thirty-minute sessions three times a week that was progressed to 60 minutes over 12 weeks. HbA1C and ABI were measured at baseline and after 12 weeks.
Results: Analysis revealed an average age of 46.75±3.59 and the duration of T2DM for developing PAD is 14.82±2.23 on average. Findings revealed that both training groups were significantly effective (p<0.000) at 95% CI in improving glycemic and vascular parameters after 12 weeks. Subsequently, findings showed that the CT group showed more significant improvement than AT group in improving HbA1C for glycemic control (p=0.002, CT: pre: 9.53±1.406, post: 7.81±0.81, AT: pre: 8.74±0.908, post: 8.15±0.83) and ABI for systemic blood flow (p=0.0001, CT: pre: 0.84±0.03, post: 0.94±0.03, AT: pre: 0.82±0.02, post: 0.86±0.02).
Conclusion: CT showed a two-fold improvement in glycemic control and arterial blood flow than AT group, which represents that CT is an effective therapeutic approach for T2DM-associated Fontain's stage IIa PAD rehabilitation.
目的:评估 CT 对改善 T2DM 相关 PAD 患者 HbA1C 和 ABI 的效果:评估 CT 对改善 T2DM 相关 PAD 患者 HbA1C 和 ABI 的效果:方法:2023 年 7 月至 9 月,卡拉奇 Ziauddin 医生医院康复科学部进行了一项随机、单盲、双臂试验。共纳入 80 名 T2DM 相关 PAD 患者,采用密封信封法随机分为实验组(40 人)和对照组(40 人)。实验组患者接受同步训练(CT),而对照组患者接受有氧训练(AT),为期 12 周。两组患者均接受每周三次、每次 30 分钟的训练,并在 12 周内将训练时间延长至 60 分钟。分别在基线和 12 周后测量 HbA1C 和 ABI:分析结果显示,患者平均年龄为(46.75±3.59)岁,T2DM 与 PAD 的关系为(14.82±2.23)年。研究结果表明,两组训练均有明显效果(p 结论:CT 对心肌梗死的治疗效果提高了两倍:CT组的血糖控制和动脉血流量比AT组改善了2倍,这表明CT是T2DM相关方丹氏IIa期PAD康复的有效治疗方法。
{"title":"Effects of concurrent training on glycemic and vascular parameters among patients with T2DM-associated Peripheral Artery Disease.","authors":"Uroosa Amin, Qurat-Ul-Ain Adnan, Tauseef Ahmad","doi":"10.12669/pjms.40.8.9045","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9045","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of CT to improve HbA1C and ABI among the T2DM-associated PAD population.</p><p><strong>Methods: </strong>A randomized, single-blinded, two-arm trial was conducted at the Department of Rehabilitation Sciences of Dr. Ziauddin Hospital in Karachi between July to September 2023. A total of 80 T2DM-associated PAD patients were included and randomly divided into Experimental Group (n=40) and Control Group (n=40), using the sealed envelope method. Experimental group patients received Concurrent Training (CT), whereas Control Group patients underwent Aerobic Training (AT) for 12 weeks. Both groups received thirty-minute sessions three times a week that was progressed to 60 minutes over 12 weeks. HbA1C and ABI were measured at baseline and after 12 weeks.</p><p><strong>Results: </strong>Analysis revealed an average age of 46.75±3.59 and the duration of T2DM for developing PAD is 14.82±2.23 on average. Findings revealed that both training groups were significantly effective (p<0.000) at 95% CI in improving glycemic and vascular parameters after 12 weeks. Subsequently, findings showed that the CT group showed more significant improvement than AT group in improving HbA1C for glycemic control (p=0.002, CT: pre: 9.53±1.406, post: 7.81±0.81, AT: pre: 8.74±0.908, post: 8.15±0.83) and ABI for systemic blood flow (p=0.0001, CT: pre: 0.84±0.03, post: 0.94±0.03, AT: pre: 0.82±0.02, post: 0.86±0.02).</p><p><strong>Conclusion: </strong>CT showed a two-fold improvement in glycemic control and arterial blood flow than AT group, which represents that CT is an effective therapeutic approach for T2DM-associated Fontain's stage IIa PAD rehabilitation.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sajjad Haider, Muhammad Zarak Awais, Eman Salik, Muhammad Tahir Iqbal
Objective: To compare the functional and radiological outcomes of treatment of volar Barton's fractures using T plate with and without distal end screws.
Methods: This randomized control trial was conducted at the department of Orthopedics, Mayo Hospital, Lahore, Pakistan from December 2021 to May 2022. Total 60 patients (30 in each group) were randomly allocated to either group A (T-Plate with distal end screws) or B (T-Plate without distal end screws). Patients were followed up on day-0, day-14, day-28 and day-90. Assessments of patients were done by Green O'Brien Score for pain, Modified Warden Score for callus formation on radiographs at 12-weeks of follow-up and Stewart Score for displacement of fracture.
Results: At 90th day, significant difference was seen in Green O'Brien Score (Excellent score: Group-A: 80% vs. Group-B: 90%, p=0.278) while Stewart scores remained comparable (Excellent Score: Group-A: 93.33% vs. Group-B: 96.67%, p=0.221) between treatment groups. Fracture healing assessed with Modified Warden score for score 4 did not show significant difference between both groups at 90th day. i.e. (Group-A: 96.67% vs. Group-B: 96.67%). However, callus formation assessed with Modified Warden score for score 3 showed significant differences between groups at 90th day. i.e. (Group-A: 53.33% vs. Group-B: 86.67%, p=0.001).
Conclusion: Both treatment approaches appear to yield comparable outcomes in terms of clinical assessment, Stewart scores, and fracture healing, with a potential advantage for T-plate without distal end screw in callus formation at the 90th day.Trial registration: IRCT20221231056999N1.
目的比较使用T型钢板(带远端螺钉)和不带远端螺钉治疗巴顿外侧骨折的功能和放射学结果:这项随机对照试验于 2021 年 12 月至 2022 年 5 月在巴基斯坦拉合尔梅奥医院骨科进行。共有 60 名患者(每组 30 人)被随机分配到 A 组(带远端螺钉的 T 型钢板)或 B 组(不带远端螺钉的 T 型钢板)。分别在第 0 天、第 14 天、第 28 天和第 90 天对患者进行随访。通过格林-奥布莱恩评分(Green O'Brien Score)评估患者的疼痛情况,通过改良沃顿评分(Modified Warden Score)评估随访12周时X光片上胼胝的形成情况,通过斯图尔特评分(Stewart Score)评估骨折的移位情况:第 90 天时,治疗组之间的格林-奥布莱恩评分有明显差异(优秀评分:A 组:80% vs. B 组:90%,P=0.278),而斯图尔特评分仍具有可比性(优秀评分:A 组:93.33% vs. B 组:96.67%,P=0.221)。在第 90 天时,用改良 Warden 评分评估骨折愈合情况(第 4 分),两组间无显著差异,即(A 组:96.67% 对 B 组:96.67%)。然而,在第 90 天时,用改良 Warden 评分 3 评估的胼胝形成情况在两组间有显著差异,即(A 组:53.33% vs. B 组:86.67%,P=0.001):结论:两种治疗方法在临床评估、Stewart评分和骨折愈合方面的效果相当,但在第90天形成胼胝方面,无远端螺钉的T型钢板可能更具优势:IRCT20221231056999N1.
{"title":"Comparison of treatment of volar Barton's fracture with T plate using distal end screws and without distal end screws.","authors":"Sajjad Haider, Muhammad Zarak Awais, Eman Salik, Muhammad Tahir Iqbal","doi":"10.12669/pjms.40.8.8799","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8799","url":null,"abstract":"<p><strong>Objective: </strong>To compare the functional and radiological outcomes of treatment of volar Barton's fractures using T plate with and without distal end screws.</p><p><strong>Methods: </strong>This randomized control trial was conducted at the department of Orthopedics, Mayo Hospital, Lahore, Pakistan from December 2021 to May 2022. Total 60 patients (30 in each group) were randomly allocated to either group A (T-Plate with distal end screws) or B (T-Plate without distal end screws). Patients were followed up on day-0, day-14, day-28 and day-90. Assessments of patients were done by Green O'Brien Score for pain, Modified Warden Score for callus formation on radiographs at 12-weeks of follow-up and Stewart Score for displacement of fracture.</p><p><strong>Results: </strong>At 90<sup>th</sup> day, significant difference was seen in Green O'Brien Score (Excellent score: Group-A: 80% vs. Group-B: 90%, p=0.278) while Stewart scores remained comparable (Excellent Score: Group-A: 93.33% vs. Group-B: 96.67%, p=0.221) between treatment groups. Fracture healing assessed with Modified Warden score for score 4 did not show significant difference between both groups at 90<sup>th</sup> day. i.e. (Group-A: 96.67% vs. Group-B: 96.67%). However, callus formation assessed with Modified Warden score for score 3 showed significant differences between groups at 90<sup>th</sup> day. i.e. (Group-A: 53.33% vs. Group-B: 86.67%, p=0.001).</p><p><strong>Conclusion: </strong>Both treatment approaches appear to yield comparable outcomes in terms of clinical assessment, Stewart scores, and fracture healing, with a potential advantage for T-plate without distal end screw in callus formation at the 90th day.Trial registration: IRCT20221231056999N1.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aimed to explore the qualitative aspects of nursing undergraduates' experience of participating in the Internet + nursing program and their spiritual education needs from the perspective of the Neuman system model.
Methods: Using a descriptive qualitative study design, twelve full-time undergraduates at Chengde Medical University from June to July 2022 who had completed their clinical internship were interviewed one-on-one, and a purposive sampling method was adopted. Moreover, Colaizzi's phenomenological method was employed to analyze the data and improve the themes.
Results: In the Internet + nursing program, the lack of spiritual education for undergraduates can be summarized into the following four themes: lack of spiritual consciousness; lack of spiritual education and spiritual nursing knowledge; high demand for spiritual education; and cognition of the current situation of basic nursing education in China and thoughts on incorporating Internet-related technologies into future nursing education.
Conclusion: At the school and hospital level, importance should be placed on the basic education of spirituality and psychological nursing, and appropriate measures should be taken to improve the knowledge level of spirituality and psychological nursing as well as the capacity of spiritual nursing, in order to ensure high-quality nursing services.
{"title":"Nursing undergraduates' experience of participating in the Internet + Nursing Program and their spiritual education needs: A qualitative study from the perspective of the Neuman System Model.","authors":"Ying Huang, Xiaotong Dong, Wei Wu, Haoran Zhang, Fei Qi","doi":"10.12669/pjms.40.8.8822","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8822","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the qualitative aspects of nursing undergraduates' experience of participating in the Internet + nursing program and their spiritual education needs from the perspective of the Neuman system model.</p><p><strong>Methods: </strong>Using a descriptive qualitative study design, twelve full-time undergraduates at Chengde Medical University from June to July 2022 who had completed their clinical internship were interviewed one-on-one, and a purposive sampling method was adopted. Moreover, Colaizzi's phenomenological method was employed to analyze the data and improve the themes.</p><p><strong>Results: </strong>In the Internet + nursing program, the lack of spiritual education for undergraduates can be summarized into the following four themes: lack of spiritual consciousness; lack of spiritual education and spiritual nursing knowledge; high demand for spiritual education; and cognition of the current situation of basic nursing education in China and thoughts on incorporating Internet-related technologies into future nursing education.</p><p><strong>Conclusion: </strong>At the school and hospital level, importance should be placed on the basic education of spirituality and psychological nursing, and appropriate measures should be taken to improve the knowledge level of spirituality and psychological nursing as well as the capacity of spiritual nursing, in order to ensure high-quality nursing services.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To compare and analyze the clinical effects of thoracoscopic lobectomy and segmentectomy in stage I non-small cell lung cancer (NSCLC).
Method: This was a retrospective study. Eighty patients with stage I NSCLC treated in Cangzhou People's Hospital from December 2019 to January 2022 were randomly divided into the segmentectomy group and lobectomy group, with 40 cases in each group. Further comparative analysis was carried out focusing on perioperative indexes, maximum ventilation volume (MVV), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), VAS score of postoperative pain and complications.
Result: There was no significant difference in the number of dissected lymph nodes and extubation time between the two groups (p>0.05). The operation time was longer, while intraoperative blood loss was less and the stay of stay in hospital was shorter in the segmentectomy group significantly than those in the lobectomy group (p<0.05). Furthermore, no significant difference was observed in MVV%, FVC% and FEV1% between the two groups before operation (p>0.05). Meanwhile, the segmentectomy group had evidently lower VAS scores at 1 d, 3 d and 5 d postoperatively than those in the lobectomy group (p<0.05). Besides, there was a much lower total incidence of complications in the segmentectomy group than that in the lobectomy group (p<0.05).
Conclusion: Compared with lobectomy, thoracoscopic segmentectomy is more effective in the treatment of stage I NSCLC, with less bleeding and mild pain, which can alleviate pulmonary function injury and reduce postoperative complications that is conducive to the improved prognosis of patients.
目的比较和分析胸腔镜肺叶切除术和肺段切除术对 I 期非小细胞肺癌(NSCLC)的临床效果:这是一项回顾性研究。将沧州市人民医院2019年12月至2022年1月收治的80例I期NSCLC患者随机分为分段切除组和肺叶切除组,每组40例。围绕围手术期指标、最大通气量(MVV)、用力肺活量(FVC)、第一秒用力呼气容积(FEV1)、术后疼痛VAS评分及并发症等进行进一步对比分析:结果:两组在切除淋巴结数量和拔管时间上无明显差异(P>0.05)。与肺叶切除术组相比,分段切除术组的手术时间更长,术中失血量更少,住院时间更短(P0.05)。同时,分段切除组在术后 1 d、3 d 和 5 d 的 VAS 评分明显低于肺叶切除组(P 结论:与肺叶切除术相比,胸腔镜下肺段切除术治疗I期NSCLC效果更好,出血少、疼痛轻,可减轻肺功能损伤,减少术后并发症,有利于改善患者预后。
{"title":"Comparative analysis of the clinical effects of different thoracoscopic resection in the treatment of Stage I Non-Small Cell Lung Cancer.","authors":"Hao Jiang, Tong Wu, Peng Qie, Huien Wang, Baoxin Zhang","doi":"10.12669/pjms.40.8.9124","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9124","url":null,"abstract":"<p><strong>Objective: </strong>To compare and analyze the clinical effects of thoracoscopic lobectomy and segmentectomy in stage I non-small cell lung cancer (NSCLC).</p><p><strong>Method: </strong>This was a retrospective study. Eighty patients with stage I NSCLC treated in Cangzhou People's Hospital from December 2019 to January 2022 were randomly divided into the segmentectomy group and lobectomy group, with 40 cases in each group. Further comparative analysis was carried out focusing on perioperative indexes, maximum ventilation volume (MVV), forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), VAS score of postoperative pain and complications.</p><p><strong>Result: </strong>There was no significant difference in the number of dissected lymph nodes and extubation time between the two groups (p>0.05). The operation time was longer, while intraoperative blood loss was less and the stay of stay in hospital was shorter in the segmentectomy group significantly than those in the lobectomy group (p<0.05). Furthermore, no significant difference was observed in MVV%, FVC% and FEV1% between the two groups before operation (p>0.05). Meanwhile, the segmentectomy group had evidently lower VAS scores at 1 d, 3 d and 5 d postoperatively than those in the lobectomy group (p<0.05). Besides, there was a much lower total incidence of complications in the segmentectomy group than that in the lobectomy group (p<0.05).</p><p><strong>Conclusion: </strong>Compared with lobectomy, thoracoscopic segmentectomy is more effective in the treatment of stage I NSCLC, with less bleeding and mild pain, which can alleviate pulmonary function injury and reduce postoperative complications that is conducive to the improved prognosis of patients.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaneez Fatima, Sughra Zulfiqar, Ammara Farooq, Musfirah Aziz
Objective: This study aimed to assess the efficacy of nasal continuous positive airway pressure (CPAP) in term and preterm neonates with respiratory distress by evaluating successful outcomes, identifying factors contributing to treatment failure, and documenting associated complications.
Method: A comparative cross-sectional study design was employed. The research was conducted at Combined Military Hospital (CMH) Rawalpindi from November 2022 to July 2023. All consecutive neonates admitted during the specified period with respiratory distress requiring CPAP treatment and meeting inclusion criteria were enrolled. Pre- and post-CPAP respiratory distress levels, relevant biochemical markers, as well as mortality and morbidity rates were documented. Both descriptive and inferential statistical analyses were employed.
Results: The mean age of the study cohort was 53.3±85.6 minutes. The average time to initiate CPAP was 82.4 ± 94.7 minutes. Mean gestational age stood at 34.68±2.8 weeks. CPAP was successful in 97% of babies. The low birth weight below 1200grams was the main factor related to failure of CPAP. The mean Downes score decreased from 5.8±1.3 before CPAP to 3.3±1.6 after 12 hours of CPAP and further to 1.85±2 after 24 hours. Significant improvements in Downes score were noted after 24 hours of CPAP usage (p < 0.05) using paired sample T-test.
Conclusion: This study affirms the effectiveness of CPAP in addressing neonatal respiratory distress. The utilization of CPAP emerges as a valuable intervention that not only reduces the requirement for invasive ventilation but also exhibits the potential to alleviate morbidity and mortality rates among neonatal populations.
{"title":"Outcome of Nasal continuous positive airway pressure in neonates: A cross-sectional study.","authors":"Kaneez Fatima, Sughra Zulfiqar, Ammara Farooq, Musfirah Aziz","doi":"10.12669/pjms.40.8.8753","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8753","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the efficacy of nasal continuous positive airway pressure (CPAP) in term and preterm neonates with respiratory distress by evaluating successful outcomes, identifying factors contributing to treatment failure, and documenting associated complications.</p><p><strong>Method: </strong>A comparative cross-sectional study design was employed. The research was conducted at Combined Military Hospital (CMH) Rawalpindi from November 2022 to July 2023. All consecutive neonates admitted during the specified period with respiratory distress requiring CPAP treatment and meeting inclusion criteria were enrolled. Pre- and post-CPAP respiratory distress levels, relevant biochemical markers, as well as mortality and morbidity rates were documented. Both descriptive and inferential statistical analyses were employed.</p><p><strong>Results: </strong>The mean age of the study cohort was 53.3±85.6 minutes. The average time to initiate CPAP was 82.4 ± 94.7 minutes. Mean gestational age stood at 34.68±2.8 weeks. CPAP was successful in 97% of babies. The low birth weight below 1200grams was the main factor related to failure of CPAP. The mean Downes score decreased from 5.8±1.3 before CPAP to 3.3±1.6 after 12 hours of CPAP and further to 1.85±2 after 24 hours. Significant improvements in Downes score were noted after 24 hours of CPAP usage (p < 0.05) using paired sample T-test.</p><p><strong>Conclusion: </strong>This study affirms the effectiveness of CPAP in addressing neonatal respiratory distress. The utilization of CPAP emerges as a valuable intervention that not only reduces the requirement for invasive ventilation but also exhibits the potential to alleviate morbidity and mortality rates among neonatal populations.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Chronic recurrent multifocal osteomyelitis is a rare autoimmune disorder causing inflammatory joint lesions. It has an estimated prevalence of 1-2 per million while adult-onset disease constitutes only 6.3% of patients.
Case report: We present a case of a 44 years old male who presented to the rheumatology clinic with lower back pain for twelve years. Magnetic resonance imaging of the lumbosacral spine showed ovoid areas of abnormal signal intensities along superior and inferior endplates of multiple vertebrae of the dorsolumbar and sacral spine. Computed tomography guided biopsy of L4 vertebrae was done. Histopathology revealed linear cores of degenerating fibrocartilage focally exhibiting small spicules of mineralized bone and fibro-collagenous tissue. He initially did not respond to traditional therapy. His symptoms improved with the addition of a Janus Kinase inhibitor. To the best of our knowledge, this is the first case of chronic recurrent multifocal osteomyelitis to be reported from Pakistan.
{"title":"Adult-onset chronic recurrent multifocal osteomyelitis: A case report of a rare entity.","authors":"Huzefa Jibril, Mehmood Riaz, Syed Ahsan Ali","doi":"10.12669/pjms.40.8.8765","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8765","url":null,"abstract":"<p><strong>Background: </strong>Chronic recurrent multifocal osteomyelitis is a rare autoimmune disorder causing inflammatory joint lesions. It has an estimated prevalence of 1-2 per million while adult-onset disease constitutes only 6.3% of patients.</p><p><strong>Case report: </strong>We present a case of a 44 years old male who presented to the rheumatology clinic with lower back pain for twelve years. Magnetic resonance imaging of the lumbosacral spine showed ovoid areas of abnormal signal intensities along superior and inferior endplates of multiple vertebrae of the dorsolumbar and sacral spine. Computed tomography guided biopsy of L4 vertebrae was done. Histopathology revealed linear cores of degenerating fibrocartilage focally exhibiting small spicules of mineralized bone and fibro-collagenous tissue. He initially did not respond to traditional therapy. His symptoms improved with the addition of a Janus Kinase inhibitor. To the best of our knowledge, this is the first case of chronic recurrent multifocal osteomyelitis to be reported from Pakistan.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Danish Muneeb, Mirza Agha Naushad Baig, Muhammad Kamran, Shafaatullah Qudratullah, Muhammad Saddique Arain
Objective: To evaluate the quality and standard of hand-written operative notes in a teaching institute.
Methods: This prospective study was carried out in the department of surgery, Fatima Hospital, Baqai Medical University, from January 2023 till May 2023. One hundred fifty operative notes from general surgery domain were considered. These notes were evaluated according to the guidelines of Royal College of Surgeons, with added-on a few variables by the author.
Results: All 150 notes were handwritten. Resident surgeon wrote the operative notes under the supervision of primary surgeon. There was a deficiency in mentioning medical record number, procedure starting time and duration of surgery. An important statement about the hemostasis is that it is secured-per-operatively was not documented. The residents were reluctant to explain the surgical procedures diagrammatically. The operative room number was missing in all notes. Post operative instructions lacked the information for nothing per oral, blood pressure, temperature, pulse rate, and input and output charting.
Conclusion: It is observed that the operative surgical notes were however explainable about the procedure, but quality and standard was not matchable with that of Royal College of Surgeons notes. Hence, a lack of formal training for the resident surgeons in operative notes writing was observed. This study is a thought provoker to the surgeons and a guide to resident trainees, and hospital management to provide a handful operative notes writing theme in the form of performa provided in the department.
{"title":"Assessing the quality and standards of operative notes in general surgery; A teaching institute's experience in Pakistan.","authors":"Muhammad Danish Muneeb, Mirza Agha Naushad Baig, Muhammad Kamran, Shafaatullah Qudratullah, Muhammad Saddique Arain","doi":"10.12669/pjms.40.8.9443","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9443","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the quality and standard of hand-written operative notes in a teaching institute.</p><p><strong>Methods: </strong>This prospective study was carried out in the department of surgery, Fatima Hospital, Baqai Medical University, from January 2023 till May 2023. One hundred fifty operative notes from general surgery domain were considered. These notes were evaluated according to the guidelines of Royal College of Surgeons, with added-on a few variables by the author.</p><p><strong>Results: </strong>All 150 notes were handwritten. Resident surgeon wrote the operative notes under the supervision of primary surgeon. There was a deficiency in mentioning medical record number, procedure starting time and duration of surgery. An important statement about the hemostasis is that it is secured-per-operatively was not documented. The residents were reluctant to explain the surgical procedures diagrammatically. The operative room number was missing in all notes. Post operative instructions lacked the information for nothing per oral, blood pressure, temperature, pulse rate, and input and output charting.</p><p><strong>Conclusion: </strong>It is observed that the operative surgical notes were however explainable about the procedure, but quality and standard was not matchable with that of Royal College of Surgeons notes. Hence, a lack of formal training for the resident surgeons in operative notes writing was observed. This study is a thought provoker to the surgeons and a guide to resident trainees, and hospital management to provide a handful operative notes writing theme in the form of performa provided in the department.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Abdur Rahman Afridi, Zafar Ali, Naveed Iqbal, Usman Zeb
Objective: To determine the frequency of new-onset diabetes mellitus (NODM) in patients with COVID-19 in a tertiary care hospital.
Method: It was a retrospective descriptive study carried out in Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa province of Pakistan from November 2021 to April 2022. All patients having new onset Diabetes Mellitus (NODM) were identified among a total of 300 patients admitted to the hospital with COVID-19 infection. Patients' data including relevant investigations were accessed through the hospital management information system (HMIS). SPSS version-23 was used for data entry and statistical analysis.
Results: Out of 300 COVID-19 patients included in the study, 163 (54.3%) were female and 137(45.7%) were male. The mean age of the patients was 56.80±13.72 (IQR 15) years. Frequency of the new onset diabetes was 44(14.7%); 19 (6.33%) male and 25(8.33%) female. Among the 44 NODM patients, the majority (57%) were female (p=0.720). Most (64%) of the patients with new-onset DM were in the middle age (p=0.018).
Conclusion: A significant number of patients with COVID-19 infection are prone to develop new-onset diabetes during their admission to the hospital.
{"title":"New-onset diabetes mellitus in patients with COVID19 infection admitted to a tertiary care hospital: A single-center experience.","authors":"Muhammad Abdur Rahman Afridi, Zafar Ali, Naveed Iqbal, Usman Zeb","doi":"10.12669/pjms.40.8.8797","DOIUrl":"https://doi.org/10.12669/pjms.40.8.8797","url":null,"abstract":"<p><strong>Objective: </strong>To determine the frequency of new-onset diabetes mellitus (NODM) in patients with COVID-19 in a tertiary care hospital.</p><p><strong>Method: </strong>It was a retrospective descriptive study carried out in Lady Reading Hospital Peshawar, Khyber Pakhtunkhwa province of Pakistan from November 2021 to April 2022. All patients having new onset Diabetes Mellitus (NODM) were identified among a total of 300 patients admitted to the hospital with COVID-19 infection. Patients' data including relevant investigations were accessed through the hospital management information system (HMIS). SPSS version-23 was used for data entry and statistical analysis.</p><p><strong>Results: </strong>Out of 300 COVID-19 patients included in the study, 163 (54.3%) were female and 137(45.7%) were male. The mean age of the patients was 56.80±13.72 (IQR 15) years. Frequency of the new onset diabetes was 44(14.7%); 19 (6.33%) male and 25(8.33%) female. Among the 44 NODM patients, the majority (57%) were female (<i>p</i>=0.720). Most (64%) of the patients with new-onset DM were in the middle age (<i>p</i>=0.018).</p><p><strong>Conclusion: </strong>A significant number of patients with COVID-19 infection are prone to develop new-onset diabetes during their admission to the hospital.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The purpose of this retrospective observational study was to evaluate the safety of newly started sedation services in the department of Radiology Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar, Pakistan.
Methods: Medical record of the patients who underwent sedation for different types of imaging studies at Shaukat Khanum Memorial Cancer Hospital, Peshawar center were retrospectively reviewed to evaluate the safety outcome of sedation. Process variables included preoperative assessment, obtaining informed consent acquisition, confirmation of nulla per os (NPO) status, monitoring during the procedure, post-anesthetic care unit (PACU) handover, and discharge instructions. The monitored complications included instances of cardiac arrest, respiratory arrest, hypoxia, apnea and vomiting.
Results: No major adverse events, such as respiratory or cardiovascular arrest, were observed among the patients in our study. A limited number of cases experienced minor events, specifically hypoxia and apnea, all of which were effectively addressed through simple maneuvers. However, one patient with previously undiagnosed obstructive sleep apnea encountered upper airway obstruction, necessitating the discontinuation of the procedure. Subsequently, all patients were safely discharged to their homes from the recovery area.
Conclusion: Sedation in Radiology department can be safely performed by adhering to a structured approach aligned with hospital policies and procedures.
{"title":"Safety Assessment of Sedation Services in Radiology at Shaukat Khanum Memorial Cancer Hospital and Research Center, Peshawar.","authors":"Faraz Mansoor","doi":"10.12669/pjms.40.8.9326","DOIUrl":"https://doi.org/10.12669/pjms.40.8.9326","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this retrospective observational study was to evaluate the safety of newly started sedation services in the department of Radiology Shaukat Khanum Memorial Cancer Hospital and Research Center Peshawar, Pakistan.</p><p><strong>Methods: </strong>Medical record of the patients who underwent sedation for different types of imaging studies at Shaukat Khanum Memorial Cancer Hospital, Peshawar center were retrospectively reviewed to evaluate the safety outcome of sedation. Process variables included preoperative assessment, obtaining informed consent acquisition, confirmation of nulla per os (NPO) status, monitoring during the procedure, post-anesthetic care unit (PACU) handover, and discharge instructions. The monitored complications included instances of cardiac arrest, respiratory arrest, hypoxia, apnea and vomiting.</p><p><strong>Results: </strong>No major adverse events, such as respiratory or cardiovascular arrest, were observed among the patients in our study. A limited number of cases experienced minor events, specifically hypoxia and apnea, all of which were effectively addressed through simple maneuvers. However, one patient with previously undiagnosed obstructive sleep apnea encountered upper airway obstruction, necessitating the discontinuation of the procedure. Subsequently, all patients were safely discharged to their homes from the recovery area.</p><p><strong>Conclusion: </strong>Sedation in Radiology department can be safely performed by adhering to a structured approach aligned with hospital policies and procedures.</p>","PeriodicalId":19958,"journal":{"name":"Pakistan Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11395387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}