Journal of the Pakistan Medical Association最新文献

Dysembryoblastic neuroepithelial tumour (DNET) are rare, benign WHO grade I glioneuronal tumours that mainly affect children and adolescents, commonly presenting with drug-resistant seizures. They typically arise in the temporal lobe cortex and show characteristic MRI features of cortical based, multicystic lesions without significant oedema or mass effect. Histologically, DNETs have a multinodular architecture with glioneuronal components and are classified into simple, complex, and nonspecific subtypes. Gross total resection is the treatment of choice, offering excellent seizure control and prognosis, while incomplete resection increases the risk of recurrence. Though malignant transformation is uncommon, reported cases highlight the importance of long-term follow-up. Early diagnosis, complete excision, and sustained surveillance are essential to achieving favourable outcomes.

Objectives: To determine the role of guy's stone score in predicting the complications rate for percutaneous nephrolithotomy.

Methods: The descriptive study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, from August 2020 to February 2021, and comprised patients undergoing percutaneous nephrolithotomy. Data was collected regarding demographic, preoperative, intraoperative and postoperative variables, including Guy's stone score and complications classified by the Clavien-Dindo system. Data was analysed with SPSS 20.

Results: Of the 118 patients, 78(66%) were males, 40(34%) were females, 71(60%) were aged >30 years and 47(40%) were aged <30 years. There was a significant correlation between a higher Guy's stone score grade and increased postoperative mild complications (p<0.0001).

Conclusions: A higher Guy's stone score did not predict severe postoperative complications among percutaneous nephrolithotomy patients.

Objectives: To assess the motivation level of undergraduate nursing students, and to explore the factors that affect their academic motivation.

Methods: The analytical, cross-sectional study was conducted from September to December 2021 at Aga Khan University School of Nursing and Midwifery, Karachi, and comprised undergraduate nursing students enrolled in the four-year Bachelor of Science in Nursing programme. Data was collected using a self-developed questionnaire which explored the motivation level of the subjects. Data was analysed using SPSS 26.

Results: Of the 233 subjects with mean age 21.1±1.56 years, 201(86.3%) were females, and 61(26.2%) were in the final year of the academic programme. Year I students had the highest mean motivation score 5.85±1.04, while final year students had the lowest score 5.66±1.23, and there was significant difference with respect to extrinsic motivation (p<0.05). Most students had joined the nursing profession because of their family's wishes 97(41.6%).

Conclusions: As motivation decreased in the final year, and the students were extrinsically motivated, faculty members' role becomes vital in promoting intrinsic motivation through the use of different teaching-learning strategies.

Long-distance running is not a recommended form of exercise after total hip arthroplasty (THA). However, younger and more active patients often wish to return to sport after THA. We present the case of a 38-year-old man who underwent bilateral THA for osteonecrosis. Three months after surgery and rehabilitation, the patient returned to his normal life. He returned to sport one year after surgery when he engaged in long-distance running and documented his daily exercise status. In the fourth year after surgery, he completed a full marathon race with a total length of 42.2km. Magnetic resonance imaging of the bilateral hip joints performed within 48 hours after the marathon revealed no oedema in the greater trochanteric region and a small amount of fluid accumulation in the hip joints. Bilateral THA achieved excellent clinical and radiographic results based on clinical manifestations and magnetic resonance imaging.

This report discusses the adaptation of a research incubator on Consultation-Liaison Psychiatry to a virtual environment, aimed at promoting research skills through experiential learning. Conducted between March 25, 2020, to June 15, 2021, in Cali, Colombia. The initiative was the result of an alliance between a teaching hospital and a medical university to foster research training competences in undergraduate medical students and psychiatry residents. Based on experiential learning principles, the programme used distance education tools to create a virtual research incubator that encouraged active engagement and collaboration. As the initiative progressed, students' interest, satisfaction and participation gradually increased, highlighting the potential of this approach. Overall, the virtual incubator proved to be a promising strategy to support research training by providing an accessible environment for experiential learning, project follow-ups and interdisciplinary collaboration.

Myeloid sarcoma (MS) is a rare extramedullary manifestation of acute myeloblastic leukaemia (AML). The presentation of MS depends on the anatomical location being affected. Myeloid sarcoma can also occur in the absence of AML, but when they occur simultaneously, they are often associated with a poorer prognosis. We report the case of an adolescent patient of AML with MS of cervical lymph nodes presenting with vague and non specific complaint of abdominal pain for two months with history of a non-specific and non-healing skin lesion on the right lower extremity. Detailed history and physical examination were a major help. Bone marrow biopsy and cervical lymph node biopsy were performed to make the definitive diagnosis. Chemotherapy and supportive care were administered. Since such cases are rarely encountered, they tend to be misdiagnosed. Reporting cases with such variable presentations can help physicians not to miss such important differential diagnoses in their evaluation.