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Bariatric Surgery: The Current Perspective 减肥手术:当前观点
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.791
Anwar Ul Haque
Obesity and overweight are defined as abnormal or excessive fat accumulation that may impair health.1 The WHO definition of overweight is a BMI > 25 and for obesity is > 30kg/m2. The National Institute of Health defines morbid obesity as a BMI of 40kg/m2 or more or a BMI of 35kg/m2 or more in the presence of obesity related comorbidities.2 Obesity has emerged as a global health crisis, affecting millions of individuals and significantly increasing the risk of chronic diseases such as diabetes, cardiovascular disorders, and certain types of cancer. As traditional methods of weight loss often prove ineffective for severely obese individuals, bariatric surgery has gained prominence as a life-altering solution. This editorial explores the transformative impact of bariatric surgery on patients' lives, shedding light on its effectiveness, safety, and long-term benefits.
肥胖和超重被定义为可能损害健康的异常或过度的脂肪积累世界卫生组织对超重的定义是BMI > 25,肥胖的定义是> 30kg/m2。美国国立卫生研究院(National Institute of Health)将病态肥胖定义为BMI≥40kg/m2或BMI≥35kg/m2并伴有肥胖相关合并症肥胖已成为全球健康危机,影响着数百万人,并显著增加了患糖尿病、心血管疾病和某些类型癌症等慢性疾病的风险。由于传统的减肥方法往往对严重肥胖的人无效,减肥手术作为一种改变生活的解决方案已经得到了重视。这篇社论探讨了减肥手术对患者生活的变革性影响,揭示了它的有效性、安全性和长期效益。
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引用次数: 0
Extended Spectrum B-Lactamase (ESBL) and Metallo B-Lactamase (MBL) Production in Gram-Negative Bacteria isolated from Urinary Tract Infection Patients. 尿路感染患者革兰氏阴性菌扩展谱b -内酰胺酶(ESBL)和金属b -内酰胺酶(MBL)的产生
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.738
Husna Shams, Muhammad Suliman, U. Noor, Asad Aziz, Sabiha Khanum, Najma Naz, Shazia Rehman
Background: The rate of infections caused by Morganella species is reported to be affected by difficulties in their isolation. Enterobacter, species, Citrobacter freundii, Serratia marcescens, and Morganella morganii are the major pathogens involved in hospital acquired infections. All of them are extensively reported in the infections of urinary tract, respiratory tract, cutaneous disorders, catheter associated infections and infections of the central nervous system.Objective: To investigate the frequency of ESBL producing bacteria in Urinary Tract Infection. Material and Methods: A cross-sectional study of 200 urine samples was collected from the outdoor patient departments of Khyber Teaching Hospital Peshawar through consecutive sampling technique during April, 2019 to June 2019. The urine samples were collected and then cultured on selective media i.e., Cysteine Lactose Electrolyte Deficient Agar (CLED) and on MacConkey agar plates. Isolates were identified by conventional morphological and biochemical tests while antibiotic susceptibility was analyzed by “Agar disc diffusion method” using different antibiotics and their zone of inhibition was measured. Results: Total 200 samples processed, 125 (62.5%) isolates, including 67 (53.6%) females, tested positive for the growth of Gram-negative bacteria. Among the identified species, 76 (60.8%) isolates produced ESBLs, with Escherichia coli accounting for 32.6%, Enterobacter for 23.2%, and Morganella species for 12.0%. Moreover, 77 (61.6%) of the isolates were found to be MBL positive, with 30 (24.0%) of them being E. coli, 28 (22.4%) being Enterobacter, and 19 (15.2%) being Morganella spp. The isolates formed a zone of inhibition like a clover leaf and demonstrated a sensitivity of 85 (68%) to antibiotics in the carbapenem class, such as imipenem and meropenem. Cefoparazone/Sulbactam 80 (64.0%), Ofloxacin 79 (63.2%), and Amikacin 78 (62.4%) were the next three antibiotics with high sensitivity. Ampicillin 106 (84.8%) showed the highest resistance, followed by Nitrofurantoin 84 (67.2%) and Ceftriaxone 79 (63.2%), in that order. Conclusion: The study indicated that ESBL-producing bacteria were present frequently among UTI patients. Most of the isolates exhibited strong carbapenem class antibiotic sensitivity. The findings of this study may contribute to the formulation of tactics to lower the incidence of ESBL-producing UTI.Keywords: Antibiotics resistance, Gram Negative bacteria, Plasmid-mediated enzymes, UTI.
背景:据报道,摩根菌引起的感染率受到其分离困难的影响。肠杆菌、弗氏柠檬酸杆菌、粘质沙雷氏菌和摩根氏菌是医院获得性感染的主要病原体。在泌尿道感染、呼吸道感染、皮肤疾病、导管相关感染和中枢神经系统感染中均有广泛报道。目的:了解尿路感染中产生ESBL细菌的频率。材料与方法:采用连续采样技术,于2019年4月至2019年6月在白沙瓦开伯尔教学医院室外病房收集200份尿液样本进行横断面研究。收集尿液样本,然后在选择性培养基上培养,即半胱氨酸乳糖电解质缺乏琼脂(半胱氨酸乳糖电解质缺乏琼脂)和麦康基琼脂板。采用常规形态学和生化试验对分离菌株进行鉴定,采用琼脂盘扩散法对不同抗生素进行药敏分析,并测定其抑菌区。结果:共处理200份样品,检出革兰氏阴性菌125株(62.5%),其中女性检出67株(53.6%);鉴定菌株中产生ESBLs的菌株76株(60.8%),其中大肠杆菌占32.6%,肠杆菌占23.2%,摩根菌占12.0%。其中,77株(61.6%)MBL阳性,其中大肠杆菌30株(24.0%)、肠杆菌28株(22.4%)、摩根菌19株(15.2%)呈三叶草状抑制带,对亚胺培南、美罗培南等碳青霉烯类抗生素的敏感性为85%(68%)。其次为头孢帕酮/舒巴坦80(64.0%)、氧氟沙星79(63.2%)和阿米卡星78(62.4%)。氨苄西林106(84.8%)、呋喃妥因84(67.2%)、头孢曲松79(63.2%)耐药最高。结论:研究表明,产esbl细菌在尿路感染患者中存在较多。大多数分离株表现出较强的碳青霉烯类抗生素敏感性。本研究结果可能有助于制定降低产esbl尿路感染发生率的策略。关键词:抗生素耐药性,革兰氏阴性菌,质粒介导酶,尿路感染
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引用次数: 0
How Common is Aspiration Pneumonia in Patients Presenting with Acute Stroke and Fed by Using Nasogastric Tube? 急性脑卒中并经鼻胃管喂养的患者吸入性肺炎有多常见?
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.753
Imtiaz Ali, Muhammad Bilal, Adeela Masood, Yaseen Khan
Background: Stroke is the leading cause of fatalities and years lost due to incapacity. Due to the possibility of pneumonia developing, aspiration has long been recognized as a substantial cause of morbidity after a stroke. Objective: To determine the frequency of aspiration pneumonia in nasogastric-tube fed stroke patients.Material and Methods: This descriptive cross-sectional study was conducted in the department of Medicine, Lady reading hospital, Peshawar from 01-12-2020 to 30-05-2021.A total of 230 patients presenting with stroke and subjected to NG tube for enteral nutrition were included in the study in a consecutive manner and checked for aspiration pneumoniaResults: The mean age of the patients was 58.7 + 9.1 years. 64.3% were males and 35.7% females. The mean duration of symptoms at presentation was 35.6 + 7.6 hours. On CT brain, 56.2% patients had ischemic stroke and 43.9% had hemorrhagic stroke. Aspiration pneumonia was recorded in 20.4%.Conclusion: Aspiration pneumonia is fairly common in our stroke patients who are on NG tube for enteral nutrition.Keywords: Acute hemorrhagic stroke, Aspiration pneumonia, Hemorrhagic stroke, Ischemic stroke, Nasogastric tube.
背景:中风是导致死亡和丧失工作能力的主要原因。由于发生肺炎的可能性,长期以来,误吸一直被认为是中风后发病的重要原因。目的:了解鼻胃管喂养脑卒中患者吸入性肺炎的发生频率。材料和方法:本描述性横断面研究于2020年1月12日至2021年5月30日在白沙瓦雷丁夫人医院医学系进行。本研究共纳入230例脑卒中患者,连续接受NG管肠内营养,检查吸入性肺炎。结果:患者平均年龄58.7±9.1岁。男性占64.3%,女性占35.7%。出现症状的平均持续时间为35.6 + 7.6小时。脑CT表现为缺血性脑卒中56.2%,出血性脑卒中43.9%。吸入性肺炎占20.4%。结论:吸入性肺炎在我们的脑卒中患者中是相当常见的。关键词:急性出血性卒中,吸入性肺炎,出血性卒中,缺血性卒中,鼻胃管
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引用次数: 0
Do not let the deaf to be deaf 不要让聋子变成聋子
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.776
Mahid Iqbal
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引用次数: 0
Spectrum of Congenital Heart Disease in Children with Down's Syndrome 唐氏综合症儿童先天性心脏病谱
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.752
Sijad Ur Rehman, Wahid Ali, Abid Iqbal, Romana Bibi
Background: Down syndrome is the most common chromosomal disorder and most common genetic cause of mental retardation.Congenital heart disease (CHD) is an important cause of morbidity and mortality in children with Down's syndrome.Objective: To determine the frequency and types of congenital heart diseases in children with Down syndrome and to relate it withconsanguinity.Material and Methods: This Cross-sectional study was carried out at Bacha Khan Medical Complex / Gajju Khan Medical College,Swabi, from January 2019-December 2020. Children less than 12 year's age with Down syndrome were enrolled in the study.Echocardiography of all these children was done and presence and type of CHD was noted.Results: Our study included 95 children with diagnosis of Down syndrome. The mean age was 56.12±41.89 months. 40% weremales. Mother's mean age was 33.04±4.2 years. Mothers having age = 35 years old were 30.5%. Parents having consanguineousmarriage were 33.7%. The diagnosis of major congenital heart defect was in 37.9%. Out of 36 CHD patients the type of congenitalheart lesion was as follows: 36.11% hadAVSD, 25% hadASD; 30.5% had VSD; 5.55% had tetralogy of Fallot and 2.78% had PDA.Children with down syndrome with CHD had older mothers <0.05. Mothers with consanguineous marriages had a greaterproportion of CHD children; p<0.05.Conclusion: Approximately 1/3rd Down syndrome children had congenital heart disease. The commonest lesion was AVSDfollowed by VSD, ASD, tetralogy of Fallot and PDA. Consanguineous marriages are associated with a greater frequency ofCHD in Down children.Keywords: Down syndrome, congenital heart disease, Echocardiography.
背景:唐氏综合症是最常见的染色体疾病,也是最常见的智力低下的遗传原因。先天性心脏病(CHD)是唐氏综合征患儿发病和死亡的重要原因。目的:了解唐氏综合征患儿先天性心脏病的发病频率、类型及其与血缘关系。材料和方法:本横断面研究于2019年1月至2020年12月在斯瓦比的Bacha Khan医疗中心/ Gajju Khan医学院进行。12岁以下患有唐氏综合症的儿童参加了这项研究。对所有患儿进行超声心动图检查,并记录冠心病的存在和类型。结果:我们的研究纳入了95名诊断为唐氏综合征的儿童。平均年龄56.12±41.89个月。weremales 40%。母亲平均年龄33.04±4.2岁。35岁的母亲占30.5%。父母近亲结婚占33.7%。主要先天性心脏缺陷的诊断率为37.9%。36例冠心病患者中,先天性心脏病变类型为:d - sd占36.11%,d - asd占25%;30.5%为室间隔缺损;5.55%为法洛四联症,2.78%为PDA。唐氏综合征合并冠心病患儿的母亲年龄<0.05。近亲婚姻的母亲患冠心病的比例更高;p < 0.05。结论:约1/3的唐氏综合征患儿有先天性心脏病。最常见的病变是avsd,其次是VSD、ASD、法洛四联症和PDA。近亲婚姻与唐氏儿童患冠心病的几率更高有关。关键词:唐氏综合征,先天性心脏病,超声心动图
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引用次数: 0
Comparison of Efficacy of Laryngeal Mask Versus I-Gel Airway Devices 喉罩与I-Gel气道装置的疗效比较
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.712
Asad Zaman, Ameer Hamza, Kaleemullah, Abdul Wahab Dogar, Zahoor Ahmed, Azhar Hussain
Background: Adequate ventilation is the primary goal of general anesthesia. A variety of supra-glottic airway devices wereintroduced to simplify airway management and minimize complications.Objective: To compare the Laryngeal mask airway versus I-Gel in terms of insertion time, number of successful insertion attempts,and changes in hemodynamic parameters in patients getting general anesthesia.Material and Methods: This comparative study was performed at the Anesthesia department, Pir Abdul Qadir Shah Institute ofMedical Sciences, Gambat from 1st July 2020 to 31st December 2020. Patients achieving the inclusion criteria were divided into twogroups. In Group-A, the I-Gel device was used for airway maintenance; while in Group-B, the Laryngeal Mask Airway(LMA) wasused. The mean insertion time, insertion attempts, and hemodynamic parameters were recorded and compared in both groups.Results: Total number of participants studied was 140; with 70 participants in each group.The mean age was 33.74+6.75 years inGroup-A and 33.16+7.24 years in Group-B. Gender distribution showed 62.86 % (n=44) male in Group-A and 64.29% (n=45) inGroup-B. A comparison of LMA versus I-Gel showed a mean insertion time of 22.81+3.09 seconds in Group-A and 31.53+2.46seconds in Group-B (p<0.0001). The number of successful insertion attempts and the changes in the hemodynamic parameterswas comparable in both groups (p>0.05).Conclusion: This study concluded that the I-Gel device has a significantly low insertion time compared to LMA in elective settings.So, its use can be handy in emergency settings.Keywords: I-Gel, LMA, General anesthesia, insertion time
背景:充分的通气是全麻的首要目标。各种各样的声门上气道设备被引入,以简化气道管理和减少并发症。目的:比较喉罩与I-Gel在全麻患者插管时间、插管成功次数及血流动力学参数的变化。材料和方法:本比较研究于2020年7月1日至2020年12月31日在Gambat Pir Abdul Qadir Shah医学科学研究所麻醉科进行。符合纳入标准的患者分为两组。a组采用I-Gel装置进行气道维持;b组采用喉罩气道(LMA)。记录并比较两组患者的平均插入时间、插入次数和血流动力学参数。结果:研究总人数140人;每组70人。a组平均年龄33.74+6.75岁,b组平均年龄33.16+7.24岁。性别分布:a组男性占62.86% (n=44), b组男性占64.29% (n=45)。LMA与I-Gel的平均插入时间A组为22.81+3.09 s, b组为31.53+2.46s (p0.05)。结论:本研究得出结论,与LMA相比,I-Gel装置在选择性设置下的插入时间明显较短。因此,在紧急情况下使用它很方便。关键词:I-Gel, LMA,全身麻醉,置入时间
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引用次数: 0
Hepatitis B Vaccination Status among Nursing Students in Karachi, Pakistan 巴基斯坦卡拉奇护生乙肝疫苗接种状况
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.636
Javid Ali, Hakim Shah, Khalilullah, Mahboob Ali, Jehanzeb Khan
Background: Hepatitis B infection is a fatal occupational hazard for health care professionals especially for student nurses. Theycan be easily protected from hepatitis B infection by their HBV vaccination.Objective: To determine the frequency of HBV Vaccination among student nurses in Karachi Pakistan.Material and Methods: This cross-sectional study was conducted in ten nursing institutes (five public and five private) among 529nursing students.Results: Out of 529 nursing students, only 270(50.6%) were vaccinated. Among 270 respondents, 58.8% were completelyvaccinated and68% were vaccinated before clinical exposure. The most common reasons for not being vaccinated included lack ofknowledge about HBV vaccine (31.88%), unavailability of free of cost vaccine (22 %), have no time for vaccination (11.96%), afraidof vaccine side effects/complications (10.14%), afraid of injection (9.42%), have prior immunity (5.43%), not effective vaccine(5.07%) and high vaccine cost (3.99%).Conclusion: There is alarmingly low vaccination coverage of hepatitis B among nursing students of Karachi, leading to a greatprofessional risk of hepatitis B infection. Consequently, policy should be implemented for making hepatitis B vaccination mandatoryfor admission in nursing institutes to prevent nursing students from acquiring this fatal disease.Keywords: Hepatitis B vaccine; Hepatitis B virus; Nursing students; Vaccination; Pakistan.
背景:乙型肝炎感染是一种致命的职业危害卫生保健专业人员,特别是学生护士。通过接种乙肝疫苗,他们可以很容易地免受乙型肝炎感染。目的:了解巴基斯坦卡拉奇地区护生接种乙肝疫苗的频率。材料与方法:本研究在10所护理学院(5所公立和5所私立)对529名护理专业学生进行横断面调查。结果:529名护生中仅有270人(50.6%)接种了疫苗。在270名应答者中,58.8%的人完全接种了疫苗,68%的人在临床暴露前接种了疫苗。不接种的主要原因为乙肝疫苗知识不足(31.88%)、没有免费疫苗(22%)、没有时间接种(11.96%)、担心疫苗副作用/并发症(10.14%)、害怕注射(9.42%)、事先免疫(5.43%)、疫苗无效(5.07%)和疫苗成本高(3.99%)。结论:卡拉奇护理专业学生乙型肝炎疫苗接种率低,导致乙肝感染的职业风险高。因此,应实施政策,强制在护理机构入学时接种乙型肝炎疫苗,以防止护生感染这种致命疾病。关键词:乙型肝炎疫苗;乙型肝炎病毒;护理学生;疫苗接种;巴基斯坦。
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引用次数: 0
How Common Peripheral Arterial Disease is in Patients Undergoing Coronary Angiography? 接受冠状动脉造影的患者中外周动脉疾病有多常见?
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.706
Shama Ayaz, Shah Zeb, Hidayatullah, Fazle Akbar, Muhammad Imran, Kareemullah, Salahudin Kamal, Mahmood ul Hassan
Background: Cardiovascular disease is the leading cause of death in the world. The detection and treatment of risk factors for CVevents is critical to improving health and longevity1. The most common among cardiovascular diseases is atherosclerotic coronaryartery disease.Objective: To determine the frequency of previously undiagnosed peripheral arterial disease in patients undergoing coronaryangiography.Material and Methods: This Descriptive Cross-sectional study was conducted in Cardiology Department, Hayatabad MedicalComplex Peshawar from 17th June, 2020 to 16th December, 2020. The patients of 40-80 years age of both genders were includedthrough Non probability consecutive sampling. The data was collected through a proforma specially designed for this study andwas analyzed through SPSS 22.Results: A total of 171 patients were included in the study. Age wise distribution among 171 patients was analyzed as 30-40 Years9(5.3%), 41-50 Years 51(29.8%), 51-60 Years 72(42.1%), 61-70 Years 32(18.7 %), 71-80 Years 7(4.1%). Mean age was55.56(±9.23) years. Gender wise distribution among patients, Male were 108(63.2%) Female were 63(36.8%). Distribution ofDiabetes Mellitus was 50(29.2%). Hypertension was documented in 100 (58.5%). Smoking Status 51(29.8%). Distribution ofperipheral arterial disease among 171 patients was analyzed as 22(12.9%). Distribution of Types ofACS was non-ST elevationamong patients was 32(18.7%), STEMI was 62(36.3%) and USA was 77 (45%).Conclusion: The study demonstrated that the frequency of asymptomatic Peripheral arterial disease (PAD) in patients with CADwas 12.9% and was strongly associated with higher incidence of cardiovascular risk factors, and multivessel disease.Keywords: Peripheral arterial disease, coronary artery disease
背景:心血管疾病是世界上导致死亡的主要原因。心血管事件危险因素的检测和治疗对于改善健康和长寿至关重要。心血管疾病中最常见的是动脉粥样硬化性冠状动脉疾病。目的:了解冠状动脉造影患者未确诊外周动脉病变的发生率。材料和方法:本描述性横断面研究于2020年6月17日至2020年12月16日在白沙瓦Hayatabad综合医院心脏病科进行。采用非概率连续抽样方法纳入40 ~ 80岁男女患者。数据通过专门为本研究设计的表格收集,并通过SPSS 22进行分析。结果:共171例患者纳入研究。171例患者的年龄分布为30-40岁9(5.3%)、41-50岁51(29.8%)、51-60岁72(42.1%)、61-70岁32(18.7%)、71-80岁7(4.1%)。平均年龄55.56(±9.23)岁。患者性别分布:男性108例(63.2%),女性63例(36.8%)。糖尿病患者50例(29.2%)。高血压100例(58.5%)。吸烟状况51人(29.8%)。171例患者中外周动脉病变分布分析为22例(12.9%)。facs类型分布为非st段抬高32例(18.7%),STEMI 62例(36.3%),USA 77例(45%)。结论:研究表明,无症状外周动脉疾病(PAD)在cad患者中的发生率为12.9%,与心血管危险因素和多血管疾病的高发生率密切相关。关键词:外周动脉疾病;冠状动脉疾病
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引用次数: 0
Euryblepharon; A Case Report From Pakistan Euryblepharon;来自巴基斯坦的病例报告
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.768
Hafiz Muhammad Jahan Zaib, Amina Khalid, Samra Ahmed
Euryblepharon is a rare congenital eyelid anomaly characterized by horizontal enlargement of the palpebral fissure. The eyelid is less in size in the vertical dimension as compared with the horizontal dimension. It may be isolated or associated with other ocular anomalies (e.g. strabismus or telecanthus) or systemic anomalies (blepharo-cheilo-odontic syndrome)There can be associated lateral canthal misalignment and as a consequence lateral ectropion. The condition was first described by Desmarres in 1854. The average length of lid fissures is different in different ages as portrayed by Duke-Elder and Cook (1963) and Waardenburg and others (1961) ranging from 18.35mm at birth to 29.68 at 24 years of age. 50% of this increase occurs during first few (3-4) years of life.
摘要大睑下垂是一种罕见的先天性眼睑异常,其特征是睑裂水平扩大。眼睑的垂直尺寸比水平尺寸小。它可能是孤立的或与其他眼部异常(如斜视或远眦)或全身性异常(眼睑-下颌-牙床综合征)相关,可能伴有侧眦错位,结果导致外眦外翻。1854年,德马雷斯首次描述了这种情况。根据Duke-Elder和Cook(1963)和Waardenburg等(1961)的研究,不同年龄的眼睑裂缝的平均长度是不同的,从出生时的18.35mm到24岁时的29.68 mm不等。其中50%的增长发生在生命的最初几年(3-4年)。
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引用次数: 0
Hepatocellular Damage in the Patients presenting with Dengue Fever 登革热患者的肝细胞损伤
Pub Date : 2023-03-10 DOI: 10.52206/jsmc.2023.13.1.765
Nazir Shah, Mian Mufarih Shah, Daneeth Kumar, Imran Qadir Khattak, Imran Khan
Background: Dengue fever is becoming endemic in Pakistan as shown by its increasing prevalence in the summer seasons foralmost the last decade. Elevation of liver enzymes indicating underlying liver damage, is a common phenomenon and may beassociated with other complications.Objective: To find out the frequency of hepatocellular damage in the patients presenting with dengue fever as evident by elevatedliver enzymes.Material and Methods: This was a descriptive study performed in the medical unit of Hayatabad Medical Complex PeshawarPakistan. Patients were consecutively collected from the wards, outpatients, and emergency department. The patient's collectionwas from the year 2022 epidemic from 10th Jul to 23rd Oct. Patients with consistent clinical features, were diagnosed on the bases ofdengue NS1 test and antibodies titers. Liver enzymes, complete blood counts and ultrasound were performed to find out anyevidence of liver damage and plasma leaks as evident by pleural effusion or ascites. Alanine aminotransferase (ALT) of more than50 U/L was considered as elevated in our study. Patients with elevated liver enzymes due to expected reasons other than denguefever as per clinical records, were excluded from the study. The patient's data was noted on a preformed Performa for furtheranalysis.Results: We consecutively collected 500 patients for the study. The number of male patients was 59% (n=295) while femalepatients were 41% (n=205). The age range was 15 to 75 years (mean 45, SD 21.32). The overall frequency of elevated (ALT) was68.2% (n=341). Stratification of patients according to the ALT level shows that only 13.68% were having anALT level of more than300 U/L. The frequency was 45.45% in patients without complications, 91.60% in patients with warning signs, 85.71% insevere dengue and 100% with acute liver failure. Patients with an alanine aminotransferase (ALT) of =>300U/L werehaving a hospital stay of 5 to 12 days (mean 8.81, SD 2.6) days verses 4 to 9 days (mean 5.8, SD 1.9) in the patients having<300U/LConclusion: Most of the patients with dengue fever have elevated alanine aminotransferase level indicative of underlyinghepatocellular damage. Such patients usually recover without any serious consequences except those having elevation of 300U/lor more whose hospital stay was prolonged, and a smaller percentage was associated with acute liver failure.Keywords: dengue fever, dengue NS1, hepatocellular damage, liver enzymes, hospital stay.
背景:登革热正在成为巴基斯坦的地方病,近十年来,登革热在夏季的流行率不断上升。肝酶升高是一种常见的现象,表明潜在的肝损伤,并可能与其他并发症有关。目的:探讨以肝酶升高为特征的登革热患者肝细胞损伤频率。材料和方法:这是一项描述性研究,在巴基斯坦白沙瓦Hayatabad医疗综合体的医疗单位进行。患者依次从病房、门诊部和急诊科收集。患者采集时间为2022年7月10日至10月23日,临床特征一致,根据登革热NS1检测和抗体滴度进行诊断。肝酶、全血细胞计数和超声检查肝损伤和血浆渗漏的证据,如胸腔积液或腹水。在我们的研究中,谷丙转氨酶(ALT)超过50 U/L被认为是升高。根据临床记录,由于登革热以外的预期原因导致肝酶升高的患者被排除在研究之外。患者的数据记录在预成型的Performa上,以便进一步分析。结果:我们连续收集了500例患者进行研究。其中男性295例,占59%,女性205例,占41%。年龄15 ~ 75岁(平均45岁,标准差21.32)。ALT升高的总频率为68.2% (n=341)。按ALT水平分层,仅13.68%的患者ALT水平大于300 U/L。无并发症患者的发生率为45.45%,有警示体征患者的发生率为91.60%,重症登革热患者的发生率为85.71%,急性肝衰竭患者的发生率为100%。谷丙转氨酶(ALT) =>300U/L的患者住院时间为5 ~ 12天(平均8.81天,SD 2.6),而ALT <300U/L的患者住院时间为4 ~ 9天(平均5.8天,SD 1.9)。结论:大多数登革热患者谷丙转氨酶水平升高,提示存在潜在的肝细胞损伤。除了300U/lor以上升高且住院时间延长的患者外,这些患者通常都能恢复,没有任何严重后果,并且与急性肝衰竭相关的比例较小。关键词:登革热,登革热NS1,肝细胞损伤,肝酶,住院。
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Journal of Saidu Medical College, Swat
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