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USE OF NUTRIENT RISK IN CRITICALLY ILL SCORE TO ASSESS NUTRITIONAL RISK IN MECHANICALLY VENTILATED PATIENTS 使用重症患者营养风险评分评估机械通气患者的营养风险
Pub Date : 2024-06-14 DOI: 10.54112/bcsrj.v2024i1.895
MA Ali, W. Ishtiaq, SU Din, MM Sajjad, S. Ali, J. Khan
Ensuring proper nutritional support is crucial for critically ill patients. This nutritional deficit is closely associated with heightened susceptibility to nosocomial infections, delayed wound healing, and an escalated risk of mortality. Objective: The objective of this study is to evaluate the effectiveness of the Nutrient Risk in Critically Ill (NUTRIC) score in assessing the nutritional risk of mechanically ventilated patients.  Method: It is a cross-sectional study. It is conducted at the Department of Critical Care Medicine, Shifa International Hospital, Islamabad from 1st Jan 2024 to 30 May 2024. The calculated sample size was 381 selected by non-probability consecutive sampling. The study utilized the modified Nutritional Risk in the Critically Ill (mNUTRIC) score to assess nutritional risk in mechanically ventilated (MV) patients. Data will be analyzed using SPSS 24.0. A P value of ≤ 5 will be significant Result: The study included a total of 381 participants, with a mean age of 55.7 ± 17.5 years and, a BMI was 23.7 ± 3.5. 219 (57.48%) had low nutritional risk (NUTRIC score ≤4), while 162 (42.51%) had high nutritional risk (NUTRIC score ≥5). Patients in the high nutritional risk group had a longer stay in the intensive care unit (ICU),  had fewer ventilator-free days and had higher mortality rates compared to those in the low nutritional risk group (8.5 ± 4.1 days vs. 5.2 ± 3.9 days, p-value < 0.01). Conclusion: The study highlights the significance of the NUTRIC score as a valuable tool for the estimation of nutritional risk among mechanically ventilated patients in the ICU setting
确保为危重病人提供适当的营养支持至关重要。营养不良与患者更易发生院内感染、伤口愈合延迟以及死亡风险增加密切相关。研究目的本研究旨在评估重症患者营养风险(NUTRIC)评分在评估机械通气患者营养风险方面的有效性。 研究方法这是一项横断面研究。研究于 2024 年 1 月 1 日至 2024 年 5 月 30 日在伊斯兰堡希法国际医院重症医学科进行。通过非概率连续抽样,计算出样本量为 381 人。研究采用改良的重症患者营养风险(mNUTRIC)评分来评估机械通气(MV)患者的营养风险。数据将使用 SPSS 24.0 进行分析。P值≤5为显著结果:研究共纳入 381 名参与者,平均年龄为 55.7 ± 17.5 岁,体重指数为 23.7 ± 3.5。219人(57.48%)营养风险较低(NUTRIC评分≤4分),162人(42.51%)营养风险较高(NUTRIC评分≥5分)。与低营养风险组患者相比,高营养风险组患者在重症监护室(ICU)的住院时间更长,无呼吸机天数更少,死亡率更高(8.5 ± 4.1 天 vs. 5.2 ± 3.9 天,P 值 < 0.01)。结论该研究强调了 NUTRIC 评分的重要性,它是估计重症监护病房机械通气患者营养风险的重要工具。
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引用次数: 0
COMPARISON OF SURGICAL WOUND CLOSURE BY STAPLES AND SUTURES 用订书机和缝合线缝合手术伤口的比较
Pub Date : 2024-06-06 DOI: 10.54112/bcsrj.v2024i1.889
Skh Shah, S. Fayaz, FR Shahid, MB Asad, SH Lone, Sara Mohydin
Surgical wound closure methods play a critical role in postoperative outcomes, with potential implications for infection rates, wound healing, and patient satisfaction. In this study, we aimed to compare the outcomes of surgical wound closure using staples versus sutures in clean elective abdominal surgeries. Objective: This prospective study aimed to assess the surgical site infection rate, closure time, and other postoperative outcomes associated with staple versus suture closure methods in clean elective abdominal surgeries. Methods: This prospective cohort study was conducted at the Pakistan Institute of Medical Sciences Hospital involving 236 patients undergoing clean elective abdominal surgeries from January 2024 to April 30, 2024. The patients were divided into two groups: the staple group (n=110) and the suture group (n=126). Baseline characteristics, including age, gender, BMI, smoking status, and comorbidities, were recorded for both groups. Surgical parameters such as mean operating time and closure time were measured. Postoperative outcomes, including surgical site infection, prolonged wound discharge (> four days), abscess formation, wound dehiscence, pain (assessed using Visual Analogue Score), and cosmetic appearance, were compared between the two groups using appropriate statistical methods. Results: The mean age of patients in the staple group was 52.45 ± 15.41 years, while in the suture group, it was 56.34 ± 14.69 years (p = 0.99). There were no significant differences in baseline characteristics between the two groups. The mean operating time was 91.13 ± 12.8 minutes in the staple group and 88.48 ± 25.55 minutes in the suture group (p = 0.17). However, the closure time was significantly shorter in the staple group (6.6 ± 1.4 minutes) compared to the suture group (15.1 ± 3.2 minutes) (p = 0.004). There were no significant differences in the rates of surgical site infection, abscess formation, or wound dehiscence between the two groups. However, the incidence of prolonged wound discharge (>4 days) was significantly higher in the staple group (11 cases) compared to the suture group (4 cases) (p = 0.001). Patients in the staple group also reported higher pain scores (Visual Analogue Score ≥ 3) compared to the suture group (p = 0.021). Additionally, the two groups had no significant difference in cosmetic appearance (p = 0.12). Conclusion: In clean elective abdominal surgeries, staple closure resulted in shorter closure times but was associated with a higher incidence of prolonged wound discharge and higher pain scores compared to suture closure. Both methods demonstrated comparable rates of surgical site infection, abscess formation, wound dehiscence, and cosmetic appearance.
手术伤口闭合方法对术后效果起着至关重要的作用,对感染率、伤口愈合和患者满意度都有潜在影响。在这项研究中,我们旨在比较在干净的腹部择期手术中使用订书机和缝合线进行手术伤口闭合的效果。目的:这项前瞻性研究旨在评估在清洁的择期腹部手术中使用订书针与缝合线闭合方法的手术部位感染率、闭合时间和其他术后效果。研究方法这项前瞻性队列研究于 2024 年 1 月至 2024 年 4 月 30 日在巴基斯坦医学科学研究所医院进行,共有 236 名接受清洁择期腹部手术的患者参与。患者被分为两组:缝合组(n=110)和缝合组(n=126)。记录了两组患者的基线特征,包括年龄、性别、体重指数、吸烟状况和合并症。测量了手术参数,如平均手术时间和缝合时间。采用适当的统计方法比较了两组患者的术后效果,包括手术部位感染、伤口出院时间延长(超过四天)、脓肿形成、伤口开裂、疼痛(采用视觉模拟评分法评估)和外观。结果订书针组患者的平均年龄为(52.45 ± 15.41)岁,缝合组患者的平均年龄为(56.34 ± 14.69)岁(P = 0.99)。两组患者的基线特征无明显差异。订书针组的平均手术时间为 91.13 ± 12.8 分钟,缝合组为 88.48 ± 25.55 分钟(p = 0.17)。不过,缝合时间方面,缝合钉组(6.6 ± 1.4 分钟)明显短于缝合线组(15.1 ± 3.2 分钟)(p = 0.004)。两组手术部位感染、脓肿形成或伤口开裂的发生率无明显差异。不过,与缝合组(4 例)相比,订书钉组(11 例)伤口长期出院(>4 天)的发生率明显更高(p = 0.001)。与缝合组相比,缝合组患者的疼痛评分(视觉模拟评分≥3)也更高(p = 0.021)。此外,两组患者在外观上没有明显差异(p = 0.12)。结论:在干净的腹部择期手术中,缝合时间较短,但伤口出院时间较长,疼痛评分较高。两种方法在手术部位感染、脓肿形成、伤口开裂和外观美观方面的发生率相当。
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引用次数: 0
FUNCTIONAL OUTCOME OF MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS AMONG PATIENTS WITH PROXIMAL TIBIA FRACTURES 胫骨近端骨折患者微创经皮钢板骨合成术的功能结果
Pub Date : 2024-06-06 DOI: 10.54112/bcsrj.v2024i1.891
M. Saeed, M. Inam, SU Haq
Proximal tibia fractures are complex injuries that pose significant challenges in orthopaedic surgery. Minimally invasive percutaneous plate osteosynthesis (MIPPO) has been increasingly adopted as a treatment method due to its potential benefits in reducing soft tissue damage and promoting faster recovery. Objective: To assess the functional outcome of minimally invasive percutaneous plate osteosynthesis (MIPPO) among patients with proximal tibia fractures. Methods: A prospective cohort study was conducted in a tertiary care hospital over a period of two years, from January 2021 to December 2022. Thirty-five patients presenting with proximal tibia fractures were treated using the MIPPO technique. The Schatzker classification was used to categorize the fractures. Functional outcomes were assessed using the Knee Society Score (KSS) at six months postoperatively. Data were analyzed using descriptive statistics and chi-square tests to determine the significance of outcomes. Results: The most frequent type of fracture, according to Schatzker's classification, was type I, followed by type II and type III. An excellent outcome was observed in 21 patients (60%), good outcomes in 8 patients (22.9%), fair outcomes in 5 patients (14.3%), and poor outcomes in 1 patient (2.9%). Postoperative complications included infection in 2 patients (5.7%). Conclusion: Minimally invasive percutaneous plate osteosynthesis (MIPPO) is a safe and effective technique for managing proximal tibia fractures, yielding excellent functional outcomes in most patients.
胫骨近端骨折是一种复杂的损伤,给骨科手术带来了巨大挑战。微创经皮钢板骨合成术(MIPPO)在减少软组织损伤和促进快速康复方面具有潜在优势,因此已被越来越多地采用为一种治疗方法。目的评估微创经皮钢板骨合成术(MIPPO)对胫骨近端骨折患者的功能效果。方法:一项前瞻性队列研究:一项前瞻性队列研究于 2021 年 1 月至 2022 年 12 月在一家三级医院进行,为期两年。35 名胫骨近端骨折患者接受了 MIPPO 技术治疗。采用 Schatzker 分类法对骨折进行分类。术后6个月采用膝关节社会评分(KSS)评估功能结果。采用描述性统计和卡方检验对数据进行分析,以确定结果的显著性。结果根据 Schatzker 的分类,最常见的骨折类型是 I 型,其次是 II 型和 III 型。21名患者(60%)的疗效为优,8名患者(22.9%)的疗效为良,5名患者(14.3%)的疗效为一般,1名患者(2.9%)的疗效为差。术后并发症包括 2 名患者(5.7%)发生感染。结论微创经皮钢板骨合成术(MIPPO)是治疗胫骨近端骨折的一种安全有效的技术,大多数患者都能获得良好的功能效果。
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引用次数: 0
FREQUENCY OF PORT SITE INFECTION IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY 腹腔镜胆囊切除术患者术孔部位感染的频率
Pub Date : 2024-06-05 DOI: 10.54112/bcsrj.v2024i1.877
S. Faris, MH Safi
Laparoscopic cholecystectomy is a common surgical procedure for the treatment of gallstones. Although considered minimally invasive, port site infections (PSI) remain a concern, potentially impacting patient outcomes and recovery times. Understanding the frequency and risk factors associated with PSI is essential for improving surgical practices and patient safety. Objective: To assess the frequency of port site infection in patients undergoing laparoscopic cholecystectomy. Methods: A cross-sectional study was conducted in the surgery department from January 2, 2024, to April 2, 2024. The study enrolled 120 patients presenting for laparoscopic cholecystectomy. The mean age of the patients was 34.30 ± 9.57 years, and the mean BMI was 25.32 ± 2.21 kg/m². The frequency of PSI was determined, and its association with BMI was analysed using statistical methods, with a significance level set at P < 0.05. Results: The PSI frequency was 6.7% (8 out of 120 patients). There was a notable association between increasing BMI and the occurrence of PSI (P = 0.005). Conclusion: The frequency of PSI in patients undergoing laparoscopic cholecystectomy in this study was 6.7%, suggesting that the procedure is relatively safe for gallbladder removal. Higher BMI was significantly associated with an increased risk of PSI, indicating the need for targeted strategies to mitigate this risk in patients with elevated BMI.
腹腔镜胆囊切除术是治疗胆结石的常见外科手术。虽然被认为是微创手术,但端口部位感染(PSI)仍然是一个令人担忧的问题,可能会影响患者的治疗效果和恢复时间。了解与 PSI 相关的频率和风险因素对于改善手术操作和患者安全至关重要。目的评估接受腹腔镜胆囊切除术的患者发生端口部位感染的频率。方法:在美国、加拿大、英国、法国、德国、意大利、日本、韩国和中国进行横断面研究:于 2024 年 1 月 2 日至 2024 年 4 月 2 日在外科进行了一项横断面研究。研究共纳入 120 名接受腹腔镜胆囊切除术的患者。患者的平均年龄为 34.30 ± 9.57 岁,平均体重指数为 25.32 ± 2.21 kg/m²。采用统计学方法确定了 PSI 的频率,并分析了其与 BMI 的关系,显著性水平设定为 P <0.05。结果显示PSI 发生率为 6.7%(120 例患者中有 8 例)。体重指数(BMI)的增加与 PSI 的发生有明显的关联(P = 0.005)。结论:在这项研究中,接受腹腔镜胆囊切除术的患者发生 PSI 的频率为 6.7%,这表明腹腔镜胆囊切除术相对安全。体重指数越高,发生 PSI 的风险就越高,这表明需要采取有针对性的策略来降低体重指数升高患者的 PSI 风险。
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引用次数: 0
TO PERFORM SERIAL ELECTROCARDIOGRAM (ECG) ANALYSES IN PATIENTS WITH SUBTLE ECG CHANGES AND EVALUATE THE PERFORMANCE OF THE FOUR-VARIABLE FORMULA IN DETECTING LEFT ANTERIOR DESCENDING (LAD) CORONARY ARTERY OCCLUSION ON CORONARY ANGIOGRAM 对有细微心电图变化的患者进行连续心电图分析,并评估四变量公式在冠状动脉造影中检测左前降支冠状动脉闭塞的性能
Pub Date : 2024-06-05 DOI: 10.54112/bcsrj.v2024i1.886
S. Ahmad, MB Siddique, RU Khan, Mor Rana, H. Siddique, M. Masoom
Acute coronary syndrome (ACS) is a critical condition that often presents with symptoms such as ‘chest pain,’ ‘shortness of breath,’ and diaphoresis, signaling a potential underlying coronary artery disease. Among the various coronary arteries, the Left Anterior Descending (LAD) artery is particularly interesting due to its significant role in supplying blood to a large portion of the heart muscle. Objectives: To assess the efficacy of the ‘four-variable formula’ in identifying left anterior descending (LAD) coronary artery occlusion, ‘serial electrocardiogram (ECG) analyses’ should be performed on individuals exhibiting minor alterations in the ‘anterior leads.’ Methodology: ‘This study was a cross-sectional study conducted at the Armed Forces Institute of Cardiology’ (AFIC) from Jan 2023 to June 2023. The primary aim was to ‘evaluate the predictive performance of the Four-Variable Formula in detecting Left Anterior Descending (LAD) coronary artery occlusion’ using serial electrocardiogram (ECG) analyses. Upon presentation, a standard 12-lead ECG was performed on each patient. Serial ECGs were conducted at 30-minute intervals for the first two hours or until a definitive diagnosis was made. Following the ECG analyses, ‘all patients were taken to the catheterization lab for coronary angiography within 24 hours of presentation’. The angiographic results served as the gold standard for diagnosing LAD occlusion. An experienced interventional cardiologist, blinded to the ECG findings, performed and interpreted the angiograms. Results: The study included 360 patients, with a mean age of 62 ±11 years (range 32-80 years). The cohort comprised 219 males (62%) and 141 females (38%). Common risk factors included hypertension (69%), diabetes mellitus (46%), smoking (51%), and a family history of coronary artery disease (29%). Coronary angiography identified LAD occlusion in 139 patients (38%) and no significant LAD occlusion in 221 patients (62%). The results suggested that the Four-Variable Formula could be integrated into routine clinical practice to enhance early detection of significant coronary artery disease, particularly in settings where immediate access to coronary angiography is limited. Future studies with more extensive, multicenter cohorts could further validate these findings and potentially lead to widespread adoption of this predictive tool. Conclusion: Our findings suggest that the Four-Variable Formula holds promise as a non-invasive diagnostic tool in emergency settings, aiding ‘in the early identification of patients at risk’ of significant coronary artery disease. By incorporating the formula into clinical practice algorithms, healthcare providers may expedite triage decisions and facilitate timely interventions, ultimately improving patient outcomes.
急性冠状动脉综合征(ACS)是一种危急病症,通常表现为 "胸痛"、"气短 "和心悸等症状,预示着潜在的冠状动脉疾病。在各种冠状动脉中,左前降支(LAD)动脉尤其引人关注,因为它在为大部分心肌供血方面发挥着重要作用。研究目的为评估 "四变量公式 "在识别左前降支(LAD)冠状动脉闭塞方面的功效,应对 "前导联 "出现轻微改变的个体进行 "连续心电图(ECG)分析"。方法:"本研究是一项横断面研究,于 2023 年 1 月至 2023 年 6 月在武装部队心脏病研究所(AFIC)进行。主要目的是利用序列心电图(ECG)分析'评估四变量公式在检测左前降支(LAD)冠状动脉闭塞方面的预测性能'。每位患者就诊时都要进行标准的 12 导联心电图检查。在最初的两小时内或在做出明确诊断之前,每隔 30 分钟进行一次序列心电图检查。在心电图分析后,"所有患者都在就诊后 24 小时内被送往导管室进行冠状动脉造影"。血管造影结果是诊断 LAD 闭塞的金标准。一位经验丰富的介入心脏病专家对心电图结果进行了盲测,并对血管造影进行了解读。研究结果研究共纳入 360 名患者,平均年龄为 62 ± 11 岁(32-80 岁不等)。其中男性 219 人(62%),女性 141 人(38%)。常见风险因素包括高血压(69%)、糖尿病(46%)、吸烟(51%)和冠心病家族史(29%)。冠状动脉造影检查发现,139 名患者(38%)存在 LAD 闭塞,221 名患者(62%)无明显 LAD 闭塞。研究结果表明,四变量公式可用于常规临床实践,以提高早期发现严重冠状动脉疾病的能力,尤其是在冠状动脉造影术无法立即进行的情况下。未来通过更广泛的多中心队列研究可以进一步验证这些发现,并有可能使这一预测工具得到广泛应用。结论:我们的研究结果表明,四变量公式有望成为急诊环境中的一种无创诊断工具,帮助 "早期识别有严重冠状动脉疾病风险的患者"。通过将该公式纳入临床实践算法,医疗服务提供者可以加快分诊决策,促进及时干预,最终改善患者预后。
{"title":"TO PERFORM SERIAL ELECTROCARDIOGRAM (ECG) ANALYSES IN PATIENTS WITH SUBTLE ECG CHANGES AND EVALUATE THE PERFORMANCE OF THE FOUR-VARIABLE FORMULA IN DETECTING LEFT ANTERIOR DESCENDING (LAD) CORONARY ARTERY OCCLUSION ON CORONARY ANGIOGRAM","authors":"S. Ahmad, MB Siddique, RU Khan, Mor Rana, H. Siddique, M. Masoom","doi":"10.54112/bcsrj.v2024i1.886","DOIUrl":"https://doi.org/10.54112/bcsrj.v2024i1.886","url":null,"abstract":"Acute coronary syndrome (ACS) is a critical condition that often presents with symptoms such as ‘chest pain,’ ‘shortness of breath,’ and diaphoresis, signaling a potential underlying coronary artery disease. Among the various coronary arteries, the Left Anterior Descending (LAD) artery is particularly interesting due to its significant role in supplying blood to a large portion of the heart muscle. Objectives: To assess the efficacy of the ‘four-variable formula’ in identifying left anterior descending (LAD) coronary artery occlusion, ‘serial electrocardiogram (ECG) analyses’ should be performed on individuals exhibiting minor alterations in the ‘anterior leads.’ Methodology: ‘This study was a cross-sectional study conducted at the Armed Forces Institute of Cardiology’ (AFIC) from Jan 2023 to June 2023. The primary aim was to ‘evaluate the predictive performance of the Four-Variable Formula in detecting Left Anterior Descending (LAD) coronary artery occlusion’ using serial electrocardiogram (ECG) analyses. Upon presentation, a standard 12-lead ECG was performed on each patient. Serial ECGs were conducted at 30-minute intervals for the first two hours or until a definitive diagnosis was made. Following the ECG analyses, ‘all patients were taken to the catheterization lab for coronary angiography within 24 hours of presentation’. The angiographic results served as the gold standard for diagnosing LAD occlusion. An experienced interventional cardiologist, blinded to the ECG findings, performed and interpreted the angiograms. Results: The study included 360 patients, with a mean age of 62 ±11 years (range 32-80 years). The cohort comprised 219 males (62%) and 141 females (38%). Common risk factors included hypertension (69%), diabetes mellitus (46%), smoking (51%), and a family history of coronary artery disease (29%). Coronary angiography identified LAD occlusion in 139 patients (38%) and no significant LAD occlusion in 221 patients (62%). The results suggested that the Four-Variable Formula could be integrated into routine clinical practice to enhance early detection of significant coronary artery disease, particularly in settings where immediate access to coronary angiography is limited. Future studies with more extensive, multicenter cohorts could further validate these findings and potentially lead to widespread adoption of this predictive tool. Conclusion: Our findings suggest that the Four-Variable Formula holds promise as a non-invasive diagnostic tool in emergency settings, aiding ‘in the early identification of patients at risk’ of significant coronary artery disease. By incorporating the formula into clinical practice algorithms, healthcare providers may expedite triage decisions and facilitate timely interventions, ultimately improving patient outcomes.","PeriodicalId":504575,"journal":{"name":"Biological and Clinical Sciences Research Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141384489","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}
引用次数: 0
EFFECT OF SEVERITY AND ETIOLOGY OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH HEART FAILURE WITH MILDLY REDUCED EJECTION FRACTION 射血分数轻度降低的心力衰竭患者慢性肾病的严重程度和病因的影响
Pub Date : 2024-06-05 DOI: 10.54112/bcsrj.v2024i1.888
HS Ramzan, A. Rawat, G. Mustafa, S. Sattar, A. Shaheen, Aaa Abdelgani, N. Lodhi, Z. Ramzan
This study explores the impact of chronic kidney disease (CKD) severity and etiology on patients with heart failure with mildly reduced ejection fraction (HFmrEF). Understanding these relationships is crucial for optimizing management strategies and improving patient outcomes. Methods: A cross-sectional study was conducted involving 550 patients diagnosed with HFmrEF. Patients were categorized based on CKD severity (stages 1 to 5) and etiology (diabetic nephropathy, hypertensive nephrosclerosis, glomerulonephritis, and others). Data on demographics, clinical characteristics, laboratory findings, and echocardiographic parameters were collected and analyzed. Results: Data were collected from 550 patients according to the study's criteria. The mean age of the patients was 62.5 ± 10.8 years. Of 550, 320 (58.2%) were male, and 230 (41.8%) were female. According to the NYHA classification, 40 (7.3%) belong to Class I, 290 (52.7%) to Class II, 200 (36.4%) to Class III, and 20 (3.6%) to Class IV. Advanced CKD stage (OR 2.5, 95% CI 1.6-3.8), diabetic nephropathy (OR 1.8, 95% CI 1.1-3.0), and lower eGFR (OR 2.2, 95% CI 1.5-3.2) were all associated with increased risk of mortality and hospitalizations. Conclusions: It is concluded that the severity and etiology of chronic kidney disease significantly impact the outcomes of patients with heart failure with mildly reduced ejection fraction. Advanced CKD stages and diabetic nephropathy are associated with higher mortality rates and more frequent hospitalizations.
本研究探讨了慢性肾病(CKD)严重程度和病因对射血分数轻度降低型心力衰竭(HFmrEF)患者的影响。了解这些关系对于优化管理策略和改善患者预后至关重要。研究方法我们对 550 名确诊为射血分数轻度降低型心力衰竭(HFmrEF)的患者进行了横断面研究。根据慢性肾脏病的严重程度(1 至 5 期)和病因(糖尿病肾病、高血压肾硬化症、肾小球肾炎及其他)对患者进行分类。收集并分析了有关人口统计学、临床特征、实验室检查结果和超声心动图参数的数据。结果根据研究标准收集了 550 名患者的数据。患者的平均年龄为(62.5 ± 10.8)岁。550 名患者中,320 名(58.2%)为男性,230 名(41.8%)为女性。根据 NYHA 分级,40 人(7.3%)属于 I 级,290 人(52.7%)属于 II 级,200 人(36.4%)属于 III 级,20 人(3.6%)属于 IV 级。慢性肾脏病晚期(OR 2.5,95% CI 1.6-3.8)、糖尿病肾病(OR 1.8,95% CI 1.1-3.0)和 eGFR 较低(OR 2.2,95% CI 1.5-3.2)都与死亡率和住院风险增加有关。结论结论:慢性肾脏疾病的严重程度和病因对射血分数轻度降低的心力衰竭患者的预后有显著影响。慢性肾脏病晚期和糖尿病肾病与更高的死亡率和更频繁的住院治疗有关。
{"title":"EFFECT OF SEVERITY AND ETIOLOGY OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH HEART FAILURE WITH MILDLY REDUCED EJECTION FRACTION","authors":"HS Ramzan, A. Rawat, G. Mustafa, S. Sattar, A. Shaheen, Aaa Abdelgani, N. Lodhi, Z. Ramzan","doi":"10.54112/bcsrj.v2024i1.888","DOIUrl":"https://doi.org/10.54112/bcsrj.v2024i1.888","url":null,"abstract":"This study explores the impact of chronic kidney disease (CKD) severity and etiology on patients with heart failure with mildly reduced ejection fraction (HFmrEF). Understanding these relationships is crucial for optimizing management strategies and improving patient outcomes. Methods: A cross-sectional study was conducted involving 550 patients diagnosed with HFmrEF. Patients were categorized based on CKD severity (stages 1 to 5) and etiology (diabetic nephropathy, hypertensive nephrosclerosis, glomerulonephritis, and others). Data on demographics, clinical characteristics, laboratory findings, and echocardiographic parameters were collected and analyzed. Results: Data were collected from 550 patients according to the study's criteria. The mean age of the patients was 62.5 ± 10.8 years. Of 550, 320 (58.2%) were male, and 230 (41.8%) were female. According to the NYHA classification, 40 (7.3%) belong to Class I, 290 (52.7%) to Class II, 200 (36.4%) to Class III, and 20 (3.6%) to Class IV. Advanced CKD stage (OR 2.5, 95% CI 1.6-3.8), diabetic nephropathy (OR 1.8, 95% CI 1.1-3.0), and lower eGFR (OR 2.2, 95% CI 1.5-3.2) were all associated with increased risk of mortality and hospitalizations. Conclusions: It is concluded that the severity and etiology of chronic kidney disease significantly impact the outcomes of patients with heart failure with mildly reduced ejection fraction. Advanced CKD stages and diabetic nephropathy are associated with higher mortality rates and more frequent hospitalizations.","PeriodicalId":504575,"journal":{"name":"Biological and Clinical Sciences Research Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141383028","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}
引用次数: 0
ESWL EFFICACY FOR VARIOUS DENSITY STONES (HU) ON PLAIN CT SCAN 普通 CT 扫描中不同密度结石(hu)的 ESWL 疗效
Pub Date : 2024-06-05 DOI: 10.54112/bcsrj.v2024i1.823
AU Rehman, S. Ullah, SF Haider, A. Sajjad
Extracorporeal Shock Wave Lithotripsy (ESWL) is a keystone in the harmless management of urinary tract stones, offering a viable alternative to surgical mediation for patients pained by urolithiasis. Objectives: The study aims to find the ESWL efficacy for various density stones (HU) on plain CT scans. Methods: This observational study was conducted at CMH Lahore from February 17, 2024, to May 16, 2024. Data were collected from 180 patients suffering from renal stones. Males represented 60% (108 patients), while females 40% (72 patients). Predominantly, stones were located in the renal pelvis (45%), followed by the upper ureter (30%) and lower ureter (25%). The mean stone size was 10 mm, ranging from 5 to 20 mm, with a corresponding mean stone density of 900 Hounsfield Units (HU) as measured on Plain CT Scan. Results: Data were collected from 180 patients. The mean age of the patients was 50.98±2.34 years. There were 60% male and 40% female patients. According to stone location, 45% are located at the renal pelvis, 30 at the upper ureter and 25% at the lower ureter. A mean reduction in the stone size of 65% post-treatment underscores the procedure's ability to facilitate stone disintegration. Stone-free rates varied based on stone density, with higher rates observed for stones with lower densities: 85% for stones ≤ 700 HU, 75% for stones > 700 HU and ≤ 1000 HU, and 65% for stones > 1000 HU. Conclusion: It is concluded that an accurate assessment of stone density and ESWL score is vital in directing treatment decisions and upgrading outcomes for patients going through ESWL for urinary stones. These findings highlight the importance of personalised treatment approaches and the potential of the ESWL score as an essential tool in clinical practice.
体外冲击波碎石术(ESWL)是无害化治疗尿路结石的关键方法,为饱受尿路结石痛苦的患者提供了手术治疗之外的另一种可行选择。研究目的研究旨在了解 ESWL 对 CT 平扫中不同密度结石(HU)的疗效。方法:本观察性研究于 2024 年 2 月 17 日至 2024 年 5 月 16 日在拉合尔 CMH 进行。研究收集了 180 名肾结石患者的数据。男性占 60%(108 名患者),女性占 40%(72 名患者)。结石主要位于肾盂(45%),其次是输尿管上段(30%)和输尿管下段(25%)。结石的平均大小为 10 毫米,从 5 毫米到 20 毫米不等,根据平扫 CT 的测量结果,结石的平均密度为 900 霍恩斯菲尔德单位(HU)。结果共收集到 180 名患者的数据。患者的平均年龄为(50.98±2.34)岁。男性患者占 60%,女性患者占 40%。根据结石位置,45%位于肾盂,30%位于输尿管上段,25%位于输尿管下段。治疗后结石大小平均缩小了 65%,这凸显了该疗法促进结石崩解的能力。无结石率因结石密度而异,密度较低的结石无结石率较高:小于700 HU的结石无石率为85%,大于700 HU且小于1000 HU的结石无石率为75%,大于1000 HU的结石无石率为65%。结论结论:准确评估结石密度和 ESWL 评分对于指导治疗决策和提高泌尿系统结石 ESWL 患者的治疗效果至关重要。这些研究结果突显了个性化治疗方法的重要性,以及ESWL评分作为临床实践中重要工具的潜力。
{"title":"ESWL EFFICACY FOR VARIOUS DENSITY STONES (HU) ON PLAIN CT SCAN","authors":"AU Rehman, S. Ullah, SF Haider, A. Sajjad","doi":"10.54112/bcsrj.v2024i1.823","DOIUrl":"https://doi.org/10.54112/bcsrj.v2024i1.823","url":null,"abstract":"Extracorporeal Shock Wave Lithotripsy (ESWL) is a keystone in the harmless management of urinary tract stones, offering a viable alternative to surgical mediation for patients pained by urolithiasis. Objectives: The study aims to find the ESWL efficacy for various density stones (HU) on plain CT scans. Methods: This observational study was conducted at CMH Lahore from February 17, 2024, to May 16, 2024. Data were collected from 180 patients suffering from renal stones. Males represented 60% (108 patients), while females 40% (72 patients). Predominantly, stones were located in the renal pelvis (45%), followed by the upper ureter (30%) and lower ureter (25%). The mean stone size was 10 mm, ranging from 5 to 20 mm, with a corresponding mean stone density of 900 Hounsfield Units (HU) as measured on Plain CT Scan. Results: Data were collected from 180 patients. The mean age of the patients was 50.98±2.34 years. There were 60% male and 40% female patients. According to stone location, 45% are located at the renal pelvis, 30 at the upper ureter and 25% at the lower ureter. A mean reduction in the stone size of 65% post-treatment underscores the procedure's ability to facilitate stone disintegration. Stone-free rates varied based on stone density, with higher rates observed for stones with lower densities: 85% for stones ≤ 700 HU, 75% for stones > 700 HU and ≤ 1000 HU, and 65% for stones > 1000 HU. Conclusion: It is concluded that an accurate assessment of stone density and ESWL score is vital in directing treatment decisions and upgrading outcomes for patients going through ESWL for urinary stones. These findings highlight the importance of personalised treatment approaches and the potential of the ESWL score as an essential tool in clinical practice.","PeriodicalId":504575,"journal":{"name":"Biological and Clinical Sciences Research Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141386126","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}
引用次数: 0
OUTCOMES OF URETERORENOSCOPY WITH PNEUMATIC LITHOCLAST FOR URETERIC STONE MANAGEMENT AT A REGIONAL CENTER: A RETROSPECTIVE STUDY 一个地区中心的输尿管造影术与气动碎石机治疗输尿管结石的结果:一项回顾性研究
Pub Date : 2024-06-05 DOI: 10.54112/bcsrj.v2024i1.878
I. Shahzad, M. Manzoor, KH Awan, MA Yousuf, GM Pathan, S. Kumar
The management of ureteric stones has significantly evolved with the advancement of minimally invasive techniques. Ureterorenoscopy (URS) with pneumatic lithoclast has become favored due to its efficacy and safety, providing high success rates across various stone locations. Objective: To share our experiences and outcomes of treating ureteric stones using ureterorenoscopy and pneumatic lithoclast at our regional center. Methods: From 2014 to 2022, 220 patients with ureteral calculi at our regional center underwent 221 URS procedures using a pneumatic lithoclast. Preoperative evaluation included plain radiography, ultrasound scan, intravenous urography, and CT KUB. Postoperative assessments with plain film radiography and, if necessary, ultrasound or CT KUB were conducted immediately or a few days after the procedure. Results: The overall stone-free rate achieved was 95.4%. Specific success rates based on stone location were 88.4% for upper, 97% for middle, and 100% for lower ureteral stones. The primary cause of treatment failure, occurring in 4.5% of cases, was stone migration. Conclusion: Ureteroscopic intra-corporeal lithotripsy is a reliable and safe treatment modality for ureteric stones of various sizes and locations, demonstrating high efficacy when performed by experienced practitioners.
随着微创技术的发展,输尿管结石的治疗也有了很大的进步。使用气动碎石机的输尿管造影术(URS)因其有效性和安全性而备受青睐,在不同结石部位的成功率都很高。目的:分享我们地区中心使用输尿管镜和气动碎石机治疗输尿管结石的经验和结果。方法:从 2014 年到 2022 年,我们地区中心的 220 名输尿管结石患者接受了 221 次使用气动碎石机的输尿管镜手术。术前评估包括X光平片、超声扫描、静脉尿路造影和KUB CT。术后即刻或几天后进行平片X光检查,必要时进行超声波或CT KUB检查。结果:总体无结石率为 95.4%。根据结石位置划分,上输尿管结石的成功率为 88.4%,中输尿管结石的成功率为 97%,下输尿管结石的成功率为 100%。4.5%的病例治疗失败的主要原因是结石移位。结论输尿管镜下体外碎石术是治疗不同大小和位置输尿管结石的一种可靠、安全的方法,由经验丰富的医生操作,疗效显著。
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引用次数: 0
INTERNATIONAL PROSTATE SYMPTOM SCORE (IPSS) CORRELATION WITH SONOGRAPHIC PROSTATE SIZE 国际前列腺症状评分(IPSS)与前列腺声像图尺寸的相关性
Pub Date : 2024-06-04 DOI: 10.54112/bcsrj.v2024i1.827
AU Rehman, S. Ullah, SF Haider, Y. Ahmed, A. Sajjad
The International Prostate Symptom Score (IPSS) is a broadly used questionnaire designed to assess the severity of lower urinary tract symptoms (LUTS) in men, particularly those related to harmless prostatic hyperplasia (BPH). Objectives: The primary aim of this study is to find the International Prostate Symptom Score (IPSS) and its correlation with sonography and prostate size. Methods: This cross-sectional study was conducted at CMH Lahore February 17, 2024, to May 16, 2024. Data were collected from 250 patients. Male patients aged>40 years who presented with LUTS were included in the study. Patients with a history of prostate cancer, bladder dysfunction and prostate surgery were excluded from the study. Data were collected through a systematically designed questionnaire. All the study participants completed the IPSS questionnaire to find the severity and urinary symptoms. Results: Data were collected from 250 patients according to the study's inclusion criteria. The mean age of the patients was 62.4 ± 8.6 years, and the mean BMI was 27.1 ± 3.2 kg/m2. The mean PSA was 6.8 ± 2.5 ng/mL, and the mean IPSS score was 19.5 ± 6.8. there, 140 (56%) patients were smokers, and 125 (50%) also suffering from hypertension. Patients with IPSS scores ranging from 0-7 exhibited a mean PV of 32.5 ± 5.6 mL, with a Pearson correlation coefficient (r) of 0.25 (p = 0.038). As IPSS scores increased to the 22-35 range, the mean PV rose to 54.3 ± 9.2 mL, with a more robust correlation coefficient of 0.75 (p < 0.001). Conclusion: It is concluded that there is a significant positive correlation between the International Prostate Symptom Score (IPSS) and prostate volume (PV) in patients with benign prostatic hyperplasia (BPH).
国际前列腺症状评分(IPSS)是一种广泛使用的调查问卷,旨在评估男性下尿路症状(LUTS)的严重程度,尤其是与无害性前列腺增生症(BPH)相关的症状。研究目的本研究的主要目的是了解国际前列腺症状评分(IPSS)及其与超声波检查和前列腺大小的相关性。研究方法:这项横断面研究是在美国加州大学洛杉矶分校进行的:这项横断面研究于 2024 年 2 月 17 日至 2024 年 5 月 16 日在拉合尔 CMH 进行。收集了 250 名患者的数据。研究对象包括年龄大于 40 岁、出现尿失禁症状的男性患者。有前列腺癌、膀胱功能障碍和前列腺手术史的患者不在研究范围内。数据通过系统设计的调查问卷收集。所有参与者都填写了 IPSS 问卷,以了解泌尿系统症状的严重程度。研究结果根据研究的纳入标准,共收集了 250 名患者的数据。患者的平均年龄为 62.4 ± 8.6 岁,平均体重指数为 27.1 ± 3.2 kg/m2。其中,140 名(56%)患者吸烟,125 名(50%)患者患有高血压。IPSS 评分为 0-7 分的患者的平均 PV 值为 32.5 ± 5.6 mL,皮尔逊相关系数(r)为 0.25(p = 0.038)。当 IPSS 分数增加到 22-35 分范围时,平均 PV 上升到 54.3 ± 9.2 mL,相关系数为 0.75(p < 0.001)。结论结论:良性前列腺增生症(BPH)患者的国际前列腺症状评分(IPSS)与前列腺体积(PV)之间存在明显的正相关。
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引用次数: 0
ASSESSMENT OF COMBINING ABILITY FOR YIELD AND YIELD RELATED TRAITS IN SPRING WHEAT (TRITICUM AESTIVUM L.) 春小麦(Triticum aestivum L.)产量及产量相关性状组合能力的评估
Pub Date : 2024-06-04 DOI: 10.54112/bcsrj.v2024i1.857
US Rana, MO Farooq, W. Abbas, B. Nasir, MS Ahmad, M. Imtiaz
Grain yield and other related characters were studied in 18 F1 generations along with nine parents (six lines and three testers) which were evaluated for combining ability with three replications in a randomized complete block design (RCBD). The results indicated that among various lines, line 9479 was identified as a good general combiner for the traits, viz.,  spike length, spikelet’s per spike, and 1000-grain weight, whereas, Line 9486 appeared as a good general combiner for the characters, flag leaf area, plant height, peduncle length, number of tillers per plant and 1000-grain weight. Line 9515 for flag leaf area, plant height, and spike length. Line 9519 for the number of tillers per plant, grain yield per plant, and plant height; line 9520 for peduncle length, number of tillers per plant, grains per spike, grain yield per plant and 9521 was identified as good general combiner for the characters spike length, spikelet’s per spike, number of grains per spike and spike density. Tester Punjab-11 emerged as a good general combiner for the traits; peduncle length, plant height, flag leaf area, and number of tillers per plant, whereas, Tester Ass-11 appeared as a good combiner for the spike length, peduncle length, 1000-grain weight, and flag leaf area. Tester Chakwal-50 identified a good general combiner for the number of tillers per plant, plant height, grains per spike, spikelets per spike, grain yield per plant, 1000-grain weight, and spike density. Out of 18 cross combinations, seven crosses viz. 9479 × Aas-11, 9486 × Aas-11, 9515 × Aas-11, 9519 × Chakwal-50, 9520 × Punjab-11, 9521 × Punjab-11, and 9521 × Aas-11 emerged with significant positive SCA effects for grain yield per plant.  Thus, these crosses can be exploited for grain yield per plant by using biparental mating system.
在随机完全区组设计(RCBD)中,对 18 个 F1 代和 9 个亲本(6 个品系和 3 个测试者)的谷物产量及其他相关性状进行了研究,并对 3 次重复的组合能力进行了评估。结果表明,在各品系中,9479 号品系被认定为穗长、每穗小穗数和千粒重等性状的良好综合组合,而 9486 号品系则被认定为旗叶面积、株高、花序梗长、每株分蘖数和千粒重等性状的良好综合组合。9515 号品系在旗叶面积、株高和穗长方面表现良好。在穗长、每穗小穗数、每穗粒数和穗密度方面,9519 号品系被认定为良好的综合配组;在花序梗长度、每穗分蘖数、每穗粒数和每穗粒重方面,9520 号品系被认定为良好的综合配组。Punjab-11 试验机在穗梗长、株高、旗叶面积和每株分蘖数等性状方面表现出良好的综合能力,而 Ass-11 试验机在穗长、穗梗长、千粒重和旗叶面积方面表现出良好的综合能力。在每株分蘖数、株高、每穗粒数、每穗小穗数、每株谷物产量、千粒重和穗密度方面,Chakwal-50 试验机是一个很好的综合组合。在 18 个杂交组合中,有 7 个杂交组合,即 9479 × Aas-11、9486 × Aas-11、9515 × Aas-11、9519 × Chakwal-50、9520 × Punjab-11、9521 × Punjab-11 和 9521 × Aas-11 对单株谷物产量具有显著的正 SCA 效应。 因此,可以利用双亲交配系统来提高这些杂交种的单株产量。
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引用次数: 0
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Biological and Clinical Sciences Research Journal
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