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IMPACT OF MALNUTRITION ON PEDIATRIC HEART FAILURE ANALYZING Z-SCORES AT PRESENTATION 营养不良对小儿心力衰竭的影响 分析发病时的 Z 值
Pub Date : 2024-03-22 DOI: 10.54112/bcsrj.v2024i1.767
ZA Yousafzai, S. Ilyas, Z. Nawab, .. Abdullah
Pediatric heart failure represents a critical health concern characterized by the heart's inability to effectively pump blood, often resulting from congenital heart defects, myocarditis, and cardiomyopathies. Malnutrition has emerged as a recognized comorbidity in pediatric heart failure, significantly impacting patient outcomes. This study aimed to investigate the relationship between malnutrition and pediatric heart failure by analyzing Z-scores at presentation to guide targeted interventions and improve patient management. The study employed a retrospective observational design and was conducted at the Department of Pediatric Cardiology, Lady Reading Hospital, Peshawar, from January 2023 to January 2024. A total of 764 pediatric patients with heart failure were included in the analysis. Nutritional status was assessed using weight and height measurements, and Z-scores were calculated based on WHO Child Growth Standards. Data analysis was performed using IBM SPSS version 22. Results revealed varying degrees of malnutrition among pediatric heart failure patients, with 62.8% classified as severely malnourished, 28.4% as moderately malnourished, and 8.8% as mildly malnourished. The calculated Z-score of -3.2 indicated significant malnutrition among the study population. Furthermore, a negative correlation (r = -0.32, p < 0.001) between Z-score and left ventricular ejection fraction was observed, suggesting a link between malnutrition severity and cardiac dysfunction. These findings underscore the high prevalence of malnutrition among pediatric heart failure patients and its substantial impact on outcomes. Early nutritional assessment and intervention are crucial for optimizing patient care and enhancing outcomes in children with heart failure. Collaborative, multidisciplinary approaches that integrate cardiac and nutritional management strategies can comprehensively address the diverse needs of this vulnerable population.
小儿心力衰竭是一种严重的健康问题,其特点是心脏无法有效泵血,通常由先天性心脏缺陷、心肌炎和心肌病引起。营养不良已成为公认的小儿心力衰竭并发症,对患者的预后有重大影响。本研究旨在通过分析发病时的 Z 评分来研究营养不良与小儿心力衰竭之间的关系,从而指导有针对性的干预措施并改善患者管理。研究采用回顾性观察设计,于2023年1月至2024年1月在白沙瓦雷丁夫人医院小儿心脏病科进行。共有 764 名患有心力衰竭的儿科患者参与了分析。营养状况通过测量体重和身高进行评估,Z 值根据世界卫生组织儿童生长标准进行计算。数据分析使用 IBM SPSS 22 版本进行。结果显示,儿科心力衰竭患者存在不同程度的营养不良,其中 62.8% 属于严重营养不良,28.4% 属于中度营养不良,8.8% 属于轻度营养不良。计算得出的 Z 值为-3.2,表明研究人群存在严重营养不良。此外,Z-分数与左心室射血分数呈负相关(r = -0.32,p < 0.001),表明营养不良严重程度与心脏功能障碍之间存在联系。这些发现强调了营养不良在小儿心力衰竭患者中的高发病率及其对预后的重大影响。早期营养评估和干预对于优化患者护理和提高心衰患儿的预后至关重要。整合心脏和营养管理策略的多学科协作方法可以全面满足这一弱势群体的不同需求。
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引用次数: 0
FREQUENCY OF TORCH INFECTION AMONG CONGENITAL CATARACT PATIENTS 先天性白内障患者火炬感染的频率
Pub Date : 2024-03-22 DOI: 10.54112/bcsrj.v2024i1.758
SA Bhutto, AA Abro, NA Katpar, DD Shaikh, SA Abbasi, PA Gul
The objective of this descriptive cross-sectional study was to determine the frequency of TORCH infections among congenital cataract patients. The study was conducted at Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from September 22, 2021, to March 21, 2022. Patients meeting the inclusion criteria, including those diagnosed with congenital cataracts and TORCH infection within the age range of one day to ten years, were included after obtaining informed consent from their guardians. A slit lamp examination was performed to identify lens opacities indicative of congenital cataracts. Subsequently, patients with congenital cataracts were sent for laboratory investigation. TORCH infections were diagnosed based on IgM levels and clinical manifestations specific to each pathogen. The results revealed that the age range of the patients included in the study was one day to ten years, with a mean age of 17.9 ± 21.8 months. Of the 85 patients with congenital cataracts, 36 (42.5%) were male, and 49 (57.5%) were female. Interestingly, TORCH infection was identified in 17 (19.6%) patients with congenital cataracts, while the remaining patients showed no evidence of TORCH infection. In conclusion, TORCH pathogens, particularly cytomegalovirus and rubella virus, were found to be frequent causative agents of congenital cataracts. These findings highlight the importance of early diagnosis and management of TORCH infections in patients with congenital cataracts to prevent visual impairment and other associated complications.
这项描述性横断面研究旨在确定先天性白内障患者中 TORCH 感染的频率。研究于 2021 年 9 月 22 日至 2022 年 3 月 21 日在拉尔卡纳沙希德-莫赫塔马-贝娜齐尔-布托医科大学进行。符合纳入标准的患者,包括被诊断患有先天性白内障和 TORCH 感染的 1 天至 10 岁年龄段的患者,在获得其监护人的知情同意后被纳入研究。对患者进行裂隙灯检查,以确定是否存在先天性白内障的晶状体混浊。随后,先天性白内障患者被送去进行实验室检查。根据 IgM 水平和每种病原体特有的临床表现诊断出 TORCH 感染。结果显示,参与研究的患者年龄范围为 1 天至 10 岁,平均年龄为(17.9 ± 21.8)个月。在 85 名先天性白内障患者中,36 名(42.5%)为男性,49 名(57.5%)为女性。有趣的是,在 17 名(19.6%)先天性白内障患者中发现了 TORCH 感染,而其余患者则没有 TORCH 感染的迹象。总之,TORCH 病原体,尤其是巨细胞病毒和风疹病毒,是先天性白内障的常见致病因子。这些发现强调了早期诊断和处理先天性白内障患者的 TORCH 感染以预防视力损伤和其他相关并发症的重要性。
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引用次数: 0
BURDEN OF ANEMIA AND ASSOCIATED FACTORS AMONG PREGNANT WOMEN AT KAUSAR HOSPITAL MOTHER AND CHILD HEALTH CARE CENTRE KHAIRPUR MIR’S, PAKISTAN 巴基斯坦 KHAIRPUR MIR'S KAUSAR 医院母婴保健中心孕妇的贫血负担及相关因素
Pub Date : 2024-03-21 DOI: 10.54112/bcsrj.v2024i1.701
N. Balouch, S. Waheed, T. Waheed, KH Memon
Anemia is the condition in which hemoglobin level may become lower than normal <11.0g/dl. According to an estimate, about one-third of the world's population (over 2 billion) are anemic. The study aimed to determine the Prevalence of anemia and associated factors among pregnant women at Kausar Hospital Mother and Child Health Care Centre Khairpur Mir’s, Sindh, Pakistan. The cross-sectional study was conducted from August to December 2019. A total number of 100 pregnant women were randomly included in this study. A predesigned questionnaire was filled out by face-to-face interviews consisting of socio-demographic characteristics, including Name, Age, gestational age, educational level, occupation, and monthly income. Anemia was classified as per World Health Organisation (WHO) criteria. The prevalence rate of Anemia in the present study was 69%. Minimum Haemoglobin levels were observed at 5.6 g/dL, and maximum Haemoglobin levels were observed at 12.4 g/dL with an average Haemoglobin of 10.05 g/dL ±1.44. Among them, 49% had mild anemia, 17% moderate anemia, and 3% severe anemia. At the same time, the patients were divided into age groups of 15-20 years, 21 to 25 years, 26 to 30 years, and 31-35 years to compare Anemia or Haemoglobin levels. Results showed a higher prevalence of anemia between the ages of 26 and 30. The minimum age was observed to be 20 years and a maximum of 35 years, with an average age of 28.12 years ±2.5 years.  It was observed that the prevalence of Anemia was higher in 7-9 gestational months; socio-economic factors (Age, Gestational month, Number of children, and income source) showed significant association with Anemia. The present study concludes that the Prevalence of Anemia and Associated Factors among Pregnant Women at Kausar Hospital was 69%. Among them, 49% had mild anemia, 17% moderate anemia, and 3% severe anemia.
贫血是指血红蛋白水平低于正常水平<11.0g/dl。据估计,全世界约有三分之一的人口(超过 20 亿)贫血。该研究旨在确定巴基斯坦信德省Kausar医院母婴保健中心Khairpur Mir's孕妇的贫血患病率及相关因素。这项横断面研究于 2019 年 8 月至 12 月进行。共有 100 名孕妇被随机纳入本研究。通过面对面访谈填写了一份预先设计的调查问卷,内容包括姓名、年龄、孕龄、教育程度、职业和月收入等社会人口学特征。贫血按世界卫生组织(WHO)的标准进行分类。本研究的贫血患病率为 69%。最低血红蛋白水平为 5.6 克/分升,最高血红蛋白水平为 12.4 克/分升,平均血红蛋白为 10.05 克/分升(±1.44)。其中,49% 患有轻度贫血,17% 患有中度贫血,3% 患有重度贫血。同时,将患者分为 15-20 岁组、21-25 岁组、26-30 岁组和 31-35 岁组,以比较贫血或血红蛋白水平。结果显示,26 岁至 30 岁的贫血患病率较高。最小年龄为 20 岁,最大年龄为 35 岁,平均年龄为 28.12 岁(±2.5 岁)。 据观察,7-9 个妊娠月份的贫血患病率较高;社会经济因素(年龄、妊娠月份、孩子数量和收入来源)与贫血有显著关联。本研究的结论是,Kausar 医院孕妇的贫血患病率及相关因素为 69%。其中,49% 患有轻度贫血,17% 患有中度贫血,3% 患有重度贫血。
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引用次数: 0
DRUG AND ALCOHOL USE IN ORTHOPAEDIC TRAUMA PATIENTS: A PROSPECTIVE STUDY 骨科创伤患者的药物和酒精使用情况:前瞻性研究
Pub Date : 2024-03-20 DOI: 10.54112/bcsrj.v2024i1.757
MU Farooque, K. Anwar, S. Hussain, MR Kifayatullah, A. Ghaffar, J. Ahmed
The objective of this study is to prospectively investigate the prevalence, patterns, and correlates of drug and alcohol use among orthopaedic trauma patients. After the ethical approval from the institutional review board, this cross-sectional study was conducted at Jinnah Postgraduate Medical Center from 01/09/23 to 29/02/24. Baseline data was collected upon admission and included demographic information (such as age and gender) and a comprehensive assessment of substance use history. Substance use was assessed using validated screening tools, including the Alcohol Use Disorders Identification Test (AUDIT) and the Drug Abuse Screening Test (DAST), to capture patterns of alcohol and drug use, frequency, duration, and any previous treatment history for substance use disorders. In the present study, the prevalence of drug and alcohol use among the orthopedic traumatic participants was (40%). Among them, the majority (51%) were using alcohol, followed by marijuana use (25%), and then cocaine (11%).  The means of hospital stay of participants in substance non-users and users (2.4±0.8 vs. 6.83±1.1; P<0.0001). Pre-injury alcohol and drug use appear to correlate with extended hospital stays among patients with traumatic orthopaedic injuries.
本研究旨在前瞻性地调查骨科创伤患者吸毒和酗酒的发生率、模式和相关因素。在获得机构审查委员会的伦理批准后,这项横断面研究于 23 年 9 月 1 日至 24 年 2 月 29 日在真纳研究生医疗中心进行。基线数据在患者入院时收集,包括人口统计学信息(如年龄和性别)和药物使用史综合评估。使用经过验证的筛查工具,包括酒精使用障碍识别测试(AUDIT)和药物滥用筛查测试(DAST),对药物使用情况进行评估,以了解酒精和药物的使用模式、频率、持续时间以及以往药物使用障碍的治疗史。在本研究中,骨科创伤参与者中吸毒和酗酒的比例为(40%)。其中,大多数人(51%)酗酒,其次是吸食大麻(25%),然后是可卡因(11%)。 非药物使用者和药物使用者的平均住院日(2.4±0.8 vs. 6.83±1.1;P<0.0001)。受伤前酗酒和吸毒似乎与创伤性骨科损伤患者住院时间延长有关。
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引用次数: 0
ASSESSMENT OF ANTERIOR CHAMBER ANGLE ON ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS WITH ANGLE CLOSURE GLAUCOMA AND ANGLE CLOSURE SUSPECTS 通过前节光学相干断层扫描评估闭角型青光眼患者和闭角型青光眼疑似患者的前房角
Pub Date : 2024-03-19 DOI: 10.54112/bcsrj.v2024i1.759
SA Bhutto, AA Leghari, NA Katpar, Z. Gopang, Dyd Shaikh, PA Gul
The objective of this cross-sectional study was to determine the anterior chamber angle using anterior segment optical coherence tomography (AS-OCT) in patients diagnosed with angle closure glaucoma and angle closure suspects. The research was conducted at Shaheed Mohtarma Benazir Bhutto Medical University Larkana, spanning from March 3, 2022, to June 30, 2023. Patients meeting the inclusion criteria and diagnosed with primary angle-closure glaucoma (PACG) were enrolled in the study after obtaining informed consent. The procedure, risks, and benefits of the study were explained to the patients before obtaining consent. AS-OCT was utilized to evaluate patients suspected of primary angle closure and those with confirmed primary angle closure. The results revealed a mean age of 56.21 ± 12.31 years among the study participants, with a confidence interval of 55.04 to 57.38. The mean duration of primary angle closure glaucoma was 22.52 ± 10.98 months, with a confidence interval of 21.47 to 23.57. Of the 423 patients included in the study, 219 (52%) were male, and 204 (48%) were female. Primary angle closure suspect and primary angle closure were observed in 47 (11%) and 44 (10%) patients, respectively. In conclusion, older age, higher central corneal thickness (CCT), and shorter axial length or presence of hyperopia were identified as important independent predictors of suspicion of primary angle closure and primary angle closure. These findings underscore the significance of thorough assessment and monitoring of these parameters in patients at risk of angle closure glaucoma.
这项横断面研究的目的是利用前节光学相干断层扫描(AS-OCT)确定被诊断为闭角型青光眼和闭角型青光眼疑似患者的前房角。研究于 2022 年 3 月 3 日至 2023 年 6 月 30 日在拉尔卡纳沙希德-莫赫塔马-贝娜齐尔-布托医科大学(Shaheed Mohtarma Benazir Bhutto Medical University Larkana)进行。符合纳入标准并确诊为原发性闭角型青光眼(PACG)的患者在获得知情同意后被纳入研究。在获得同意之前,已向患者解释了研究的程序、风险和益处。利用 AS-OCT 对疑似原发性闭角和确诊为原发性闭角的患者进行评估。结果显示,研究参与者的平均年龄为(56.21 ± 12.31)岁,置信区间为 55.04 至 57.38 岁。原发性闭角型青光眼的平均病程为(22.52 ± 10.98)个月,置信区间为 21.47 至 23.57 个月。在研究的 423 名患者中,219 名(52%)为男性,204 名(48%)为女性。分别有 47 名(11%)和 44 名(10%)患者出现原发性闭角怀疑和原发性闭角。总之,年龄较大、角膜中央厚度(CCT)较高、轴向长度较短或存在远视被认为是原发性角膜闭合怀疑和原发性角膜闭合的重要独立预测因素。这些发现强调了对有闭角型青光眼风险的患者进行全面评估和监测这些参数的重要性。
{"title":"ASSESSMENT OF ANTERIOR CHAMBER ANGLE ON ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS WITH ANGLE CLOSURE GLAUCOMA AND ANGLE CLOSURE SUSPECTS","authors":"SA Bhutto, AA Leghari, NA Katpar, Z. Gopang, Dyd Shaikh, PA Gul","doi":"10.54112/bcsrj.v2024i1.759","DOIUrl":"https://doi.org/10.54112/bcsrj.v2024i1.759","url":null,"abstract":"The objective of this cross-sectional study was to determine the anterior chamber angle using anterior segment optical coherence tomography (AS-OCT) in patients diagnosed with angle closure glaucoma and angle closure suspects. The research was conducted at Shaheed Mohtarma Benazir Bhutto Medical University Larkana, spanning from March 3, 2022, to June 30, 2023. Patients meeting the inclusion criteria and diagnosed with primary angle-closure glaucoma (PACG) were enrolled in the study after obtaining informed consent. The procedure, risks, and benefits of the study were explained to the patients before obtaining consent. AS-OCT was utilized to evaluate patients suspected of primary angle closure and those with confirmed primary angle closure. The results revealed a mean age of 56.21 ± 12.31 years among the study participants, with a confidence interval of 55.04 to 57.38. The mean duration of primary angle closure glaucoma was 22.52 ± 10.98 months, with a confidence interval of 21.47 to 23.57. Of the 423 patients included in the study, 219 (52%) were male, and 204 (48%) were female. Primary angle closure suspect and primary angle closure were observed in 47 (11%) and 44 (10%) patients, respectively. In conclusion, older age, higher central corneal thickness (CCT), and shorter axial length or presence of hyperopia were identified as important independent predictors of suspicion of primary angle closure and primary angle closure. These findings underscore the significance of thorough assessment and monitoring of these parameters in patients at risk of angle closure glaucoma.","PeriodicalId":504575,"journal":{"name":"Biological and Clinical Sciences Research Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140229964","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
COMPARISON OF THE VARIABILITY OF RECOVERY PROFILE AND HEMODYNAMIC EFFECTS OF NEUROMUSCULAR BLOCKADE WITH CISATRACURIUM VERSUS ATRACURIUM 顺式阿曲库铵与阿曲库铵神经肌肉阻断术的恢复曲线和血流动力学效应的变异性比较
Pub Date : 2024-03-19 DOI: 10.54112/bcsrj.v2024i1.761
A. Siddiqui, S. Raza, S. Shafqat, S. Zehra, S. Bozdar, MN Munir
A randomized controlled trial was conducted at the Main Operation Theatre of Jinnah Postgraduate Medical Centre (JPMC) in Karachi to compare the recovery profile and hemodynamic effects of cisatracurium and atracurium among patients undergoing laparoscopic cholecystectomy. The study was conducted from 20th July 2019 to 19th January 2020 and included 68 patients aged between 20 to 50 years undergoing elective laparoscopic cholecystectomy under general anesthesia. Patients with a history of allergy to the study drugs, neuromuscular, pulmonary, renal, or hepatic diseases, smoking, pregnancy, or breastfeeding, and those on preoperative medication such as antipsychotics, aminoglycosides, steroids, or neuroleptics were excluded. The patients were randomly divided into two groups. In Group 1, comprising 34 patients, cisatracurium (0.2 mg/kg) was administered, whereas in Group 2, also with 34 patients, atracurium (0.5 mg/kg) was given. Neuromuscular blocking agents were administered three minutes before intubation. The primary outcomes measured were the recovery profile and hemodynamic effects. In Group 1 (cisatracurium), the baseline mean arterial pressure (MAP) was recorded as 98.40 ± 8.02 mmHg, which increased to 112.20 ± 8.88 mmHg before intubation, resulting in a change of 13.56 ± 5.59 mmHg. In contrast, in Group 2 (atracurium), the baseline MAP was 94.10 ± 7.91 mmHg, which rose to 109.07 ± 8.35 mmHg before intubation, indicating a change of 16.50 ± 4.38 mmHg. The study concluded that cisatracurium is more effective in exhibiting neuromuscular blocking properties than atracurium in patients undergoing laparoscopic cholecystectomy under general anesthesia.
卡拉奇真纳研究生医疗中心(JPMC)主手术室进行了一项随机对照试验,以比较顺阿曲库铵和阿曲库铵对接受腹腔镜胆囊切除术的患者的恢复情况和血流动力学影响。该研究于 2019 年 7 月 20 日至 2020 年 1 月 19 日进行,纳入了 68 名在全身麻醉下接受择期腹腔镜胆囊切除术的 20 至 50 岁患者。有研究药物过敏史、神经肌肉疾病、肺病、肾病或肝病、吸烟、妊娠或哺乳以及术前服用抗精神病药物、氨基糖苷类药物、类固醇或神经抑制剂等药物的患者被排除在外。患者被随机分为两组。第一组有 34 名患者,使用顺卡曲铵(0.2 毫克/千克);第二组也有 34 名患者,使用阿曲库铵(0.5 毫克/千克)。插管前三分钟使用神经肌肉阻断剂。测量的主要结果是恢复情况和血液动力学效应。第 1 组(顺阿曲库铵)的基线平均动脉压(MAP)记录为 98.40 ± 8.02 mmHg,插管前升至 112.20 ± 8.88 mmHg,变化幅度为 13.56 ± 5.59 mmHg。相比之下,第 2 组(阿曲库铵)的基线 MAP 为 94.10 ± 7.91 mmHg,插管前升至 109.07 ± 8.35 mmHg,变化幅度为 16.50 ± 4.38 mmHg。研究得出结论,在全身麻醉下接受腹腔镜胆囊切除术的患者中,顺式阿曲库铵比阿曲库铵更有效地表现出神经肌肉阻滞特性。
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引用次数: 0
THE ANATOMY OF BONE HEALING: BONE REGENERATION IN ORTHOPEDIC MEDICINE 骨愈合的解剖学:骨科医学中的骨再生
Pub Date : 2024-03-18 DOI: 10.54112/bcsrj.v2024i1.754
Qua Khan, F. Malik, Saz Naqvi, T. Kausar, T. Raza, A. Mansoor
Bone regeneration is a physiological bone formation process involved in routine fracture healing and continuous remodeling throughout adult life. The study's main objective is to determine the role of orthopedic medicines in bone regeneration and healing process. This retrospective study was conducted in a public hospital in Karachi, Pakistan, from February 2023 to June 2023. The study aimed to collect data from 120 bone fracture patients and evaluate the progression of bone healing to identify critical determinants of successful regeneration. Clinical assessments, radiological imaging, and histopathological analyses were conducted to achieve the study's objectives. The study collected data from 120 patients, with a mean age of 45.21±12.3 years. Of these, 70 were male and 50 were female. Upper extremities accounted for 40% of fractures, lower extremities 30%, and axial skeleton 30%. Simple fractures accounted for 50% of cases, while comminuted fractures represented 30% and open fractures 20%. There was a strong positive correlation between fracture severity and the time required for radiographic union, with a correlation coefficient (r) of 0.65 (p < 0.001). Additionally, biomarkers of bone turnover exhibited a moderate positive correlation with radiological healing, with a correlation coefficient (r) of 0.45 (p = 0.003). The study concludes that orthopedic interventions have a high success rate in achieving satisfactory outcomes, with the majority of patients experiencing successful bone healing and restoration of function.
骨再生是一种生理性的骨形成过程,涉及成年后的常规骨折愈合和持续重塑。本研究的主要目的是确定骨科药物在骨再生和愈合过程中的作用。这项回顾性研究于 2023 年 2 月至 2023 年 6 月在巴基斯坦卡拉奇的一家公立医院进行。研究旨在收集 120 名骨折患者的数据,评估骨愈合的进展情况,以确定成功再生的关键决定因素。为实现研究目标,进行了临床评估、放射成像和组织病理学分析。研究收集了 120 名患者的数据,平均年龄为(45.21±12.3)岁。其中 70 人为男性,50 人为女性。上肢骨折占 40%,下肢骨折占 30%,轴骼骨折占 30%。单纯骨折占 50%,粉碎性骨折占 30%,开放性骨折占 20%。骨折严重程度与放射学愈合所需时间之间存在很强的正相关性,相关系数(r)为 0.65(p < 0.001)。此外,骨转换生物标志物与放射学愈合呈中度正相关,相关系数(r)为 0.45(p = 0.003)。研究得出结论,骨科干预在取得满意疗效方面成功率很高,大多数患者的骨愈合和功能恢复都很成功。
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引用次数: 0
SEDATION DEPTH DURING CRITICAL CARE TRANSPORT AND HOSPITALIZATION 重症监护转运和住院期间的镇静深度
Pub Date : 2024-03-18 DOI: 10.54112/bcsrj.v2024i1.756
M. Haroon, .. Sulaiman, MJ Khan, I. Haq, S. Ahmad, S. Malik
The purpose of this study was to determine the differences in attained levels of sedation both within intensive care units and collectively regarding overall outcomes when patients were transported outside a hospital either pre-hospital or while being inter-facility transfer by different critical care agencies, having been exposed to light versus deep quality of anaesthesia. After the ethical approval from the institutional review board, this cross-sectional study was conducted at Khyber Teaching Hospital from 01/06/22 to 31/12/22. The primary outcome measure was the relation of starting deep sedation during transport to deep sedation in the first 48 hours after admission (defined as RASS -3 and less). Secondary outcomes included mechanical ventilation duration, inpatient mortality, total hospital stay length of ICU, and delirium within 48 h; coma may also be observed. Final transport RASS in both the study groups was-4.43±0.49 and-1.5±0.5 (p <0.0001). Mean Hospital duration in both study groups was 13.01±4.8 and 35±5.9 days (p<0.0001). A high percentage of inpatient mortality, delirium, and coma cases was seen in the deep sedation group (p<0.0001). The transfer of patient care from the transport team to the hospital team presents a chance to potentially interrupt the progress of treatment and reassess decisions regarding sedation.
本研究的目的是确定重症监护病房内达到的镇静水平的差异,以及不同重症监护机构在院前或医院间转运病人时,病人在接受轻度和深度麻醉后,总体结果的差异。在获得机构审查委员会的伦理批准后,这项横断面研究于 2012 年 6 月 1 日至 12 月 31 日在开伯尔教学医院进行。主要结果指标是转运过程中开始深度镇静与入院后 48 小时内深度镇静(定义为 RASS -3 及以下)的关系。次要结果包括机械通气持续时间、住院患者死亡率、重症监护室总住院时间和 48 小时内的谵妄;也可观察到昏迷。两个研究组的最终转运 RASS 分别为-4.43±0.49 和-1.5±0.5(P <0.0001)。两组患者的平均住院时间分别为(13.01±4.8)天和(35±5.9)天(P<0.0001)。深度镇静组的住院死亡率、谵妄和昏迷病例比例较高(P<0.0001)。将患者护理从转运团队转移到医院团队是一个机会,有可能中断治疗进程并重新评估有关镇静的决定。
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引用次数: 0
CHALLENGES FACED BY NURSING STUDENTS IN ONLINE EDUCATION DURING THE COVID-19 PANDEMIC 科维德-19 大流行期间护理专业学生在在线教育中面临的挑战
Pub Date : 2024-03-18 DOI: 10.54112/bcsrj.v2024i1.755
B. Farid, M. Zafar, K. Rasheed, H. Arshad
Amid the COVID-19 pandemic, the transition to online education has posed significant challenges for nursing students worldwide. This study explores the multifaceted obstacles encountered during this shift and aims to provide insights for improving online nursing education. Utilizing a descriptive cross-sectional quantitative research design, data was collected from 73 final-year nursing students at Saida Waheed FMH College of Nursing, Lahore, using a structured questionnaire. The questionnaire assessed various domains, including learning effectiveness, software proficiency, instructor support, communication, course design, and psychosocial experiences. The results revealed a spectrum of student experiences, ranging from perceived benefits to substantial challenges adapting to online learning. While some students reported proficiency in online education tools, others faced difficulties navigating technology and accessing course materials. Instructor support emerged as a critical factor influencing students' satisfaction and learning outcomes, with clear communication and timely feedback paramount. Additionally, challenges related to course design and psychosocial experiences significantly impacted students' engagement and motivation. By comparing these findings with previous research, common themes and areas for improvement in online nursing education were identified. The study underscores the importance of targeted interventions to address technological barriers, enhance instructional support, optimize course design, and prioritize students' psychosocial well-being in online learning environments. Ultimately, these insights can inform the development of effective strategies to enhance the quality and effectiveness of online nursing education programs.
在 COVID-19 大流行的背景下,向在线教育的过渡给全世界的护理专业学生带来了巨大的挑战。本研究探讨了在这一转变过程中遇到的多方面障碍,旨在为改进在线护理教育提供启示。本研究采用描述性横断面定量研究设计,使用结构化问卷从拉合尔 Saida Waheed FMH 护理学院 73 名护理专业毕业班学生中收集数据。问卷评估了多个领域,包括学习效率、软件熟练程度、教师支持、沟通、课程设计和社会心理体验。调查结果显示,学生的体验各不相同,有的认为在线学习有益,有的则认为在适应在线学习方面面临巨大挑战。一些学生表示能够熟练使用在线教育工具,而另一些学生则在掌握技术和获取课程资料方面遇到困难。教师的支持是影响学生满意度和学习成果的关键因素,其中最重要的是清晰的沟通和及时的反馈。此外,与课程设计和社会心理体验相关的挑战也极大地影响了学生的参与度和积极性。通过将这些发现与之前的研究进行比较,确定了在线护理教育的共同主题和需要改进的地方。这项研究强调了有针对性的干预措施的重要性,以解决在线学习环境中的技术障碍、加强教学支持、优化课程设计并优先考虑学生的社会心理健康。最终,这些见解可以为制定有效策略提供参考,从而提高在线护理教育项目的质量和有效性。
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引用次数: 0
EFFECTS OF ANTICOAGULANTS ON BLOOD CELLS MORPHOLOGY AND BIOCHEMISTRY 抗凝剂对血细胞形态和生物化学的影响
Pub Date : 2024-03-14 DOI: 10.54112/bcsrj.v2024i1.663
A. Arshad, A. Safdar, M. Atif, H. Hussain, M. Waqas, S. Mahmood
Blood is a particular type of connective tissue that majorly contains red blood cells (RBCs), white blood cells (WBCs), and platelets (Plts). Anticoagulants are used to preserve the fluidity of blood and retard morphological changes in blood cells. Anticoagulants like EDTA, heparin, sodium citrate, and CPDA-1 are used. However, these anticoagulants also have some disadvantages, summarized in this review. This chemical causes the lysis of many cells, including RBCs, and some of them, like EDTA, cause agglutination of platelets, which not only causes a decrease in platelet count but also causes a spurious increase in WBC count. These substances also alter the shapes of various cells present in blood. RBCs and platelets may become spherical from the normal biconcave disc and plate-like structures. Commonly used anticoagulants contribute to alterations of many hematological parameters, including hematocrit, hemoglobin concentration, and packed cell volume of RBCs. Certain chemicals used in anticoagulant solutions, such as potassium and sodium in EDTA solution, make the blood unsuitable for determining these electrolytes in the sample. They also induce many changes in the biochemical composition of the sample. The most affected biochemical changes are observed in 2,3-DPG, D-dimer concentration, blood gas estimation, and cytokine levels. As they contain different chemicals, they have varying pH, so they alter blood pH.
血液是一种特殊的结缔组织,主要含有红细胞(RBC)、白细胞(WBC)和血小板(Plts)。抗凝剂用于保持血液的流动性和延缓血细胞的形态变化。可使用 EDTA、肝素、柠檬酸钠和 CPDA-1 等抗凝剂。然而,这些抗凝剂也有一些缺点,本综述对此进行了总结。这种化学物质会导致包括红细胞在内的许多细胞溶解,其中一些物质(如 EDTA)会导致血小板凝集,这不仅会导致血小板数量减少,还会造成白细胞数量的虚假增加。这些物质还会改变血液中各种细胞的形状。红细胞和血小板会从正常的双凹盘状和板状结构变成球状。常用的抗凝剂会导致许多血液参数发生变化,包括血细胞比容、血红蛋白浓度和红细胞的包装细胞体积。抗凝剂溶液中使用的某些化学物质,如 EDTA 溶液中的钾和钠,会使血液样本中的这些电解质变得不适合测定。它们还会导致样本的生化成分发生许多变化。受影响最大的生化变化是 2,3-DPG、D-二聚体浓度、血气估计值和细胞因子水平。由于含有不同的化学物质,它们的 pH 值各不相同,因此会改变血液的 pH 值。
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Biological and Clinical Sciences Research Journal
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