Journal of the Pakistan Medical Association最新文献

The emergence of innovative electronic devices has revolutionized the role of medicine, specifically telemedicine and telerehabilitation. A smartwatch is similar in shape to a traditional wristwatch with a built-in, networked computer with an array of sensors. The use of smartwatches has provided healthcare workers with new opportunities for monitoring and managing health. Monitoring of vitals like heart rate, blood pressure, and oxygen saturation, has been made possible by the help of smartwatches. These features provide the wearer with a real-time picture of their health. Monitoring of vital health parameters over time can help detect irregularities in health status and can also be used for remote patient monitoring. This enables healthcare professionals to monitor their patient's health from anywhere. Smartwatches are being used in physical rehabilitation nowadays for monitoring vitals during physical therapy and tracking the progress of the wearer. This mini-review discusses insights into the benefits of using smartwatches in healthcare, and focuses on the evolving role of smartwatches in telerehabilitation.

Objective: To determine the distribution pattern and possible reasons of delayed diagnosis of congenital heart disease in adult population.

Methods: The analytical, cross-sectional study was conducted at the Department of Paediatric Cardiology, National Institute of Cardiovascular Diseases, Karachi, from July to December 2021, and comprised patients of either gender aged 18 years and above with congenital heart disease confirmed by echocardiographic examination. Age, gender, weight, height, provincial affiliation, marital status, number of children, if any, duration of disease and New York Heart Association classification were noted on a predesigned proforma. Patterns of congenital heart disease types and reasons behind delayed diagnosis, if noted, were recorded. Data was analysed using SPSS 26.

Results: Of the 129 patients, 68(52.7%) were males. The overall mean age was 25.8±9.8 years. Mean age at the time of diagnosis was 12.4±14.8 years. There were 91(70.5%) cases with delayed diagnosis. There was no significant gender difference with respect to delayed diagnosis (p>0.05). Delayed referral 39(42.9%), delayed consultation 22(24.2%), delayed diagnosis by the doctor 21(23.1%), and social factors 9(9.9%) were the most frequent reasons behind delayed diagnosis. Ventricular septal defect was the most frequently defect 38(29.5%), followed by Tetralogy of Fallot 32(24.8%). Right ventricular dysfunction was the most common complication of delayed diagnosis 35(27.1%).

Conclusions: Delayed diagnosis of congenital heart disease was reported in over two-thirds of the cases, with ventricular septal defect being the most frequent type of defect, and delayed referral being the most common reason.

Cerebellar high-grade gliomas (cHGG) are uncommon in adults, making up only about 1% of all high-grade gliomas. These tumours differ from supratentorial high-grade gliomas (sHGG) in terms of epidemiology, molecular traits, and the age of the patients. cHGG patients are typically younger and show a higher frequency of neurofibromatosis 1 (NF1) mutations, atypical RAS mutations, and H3K27M mutations. Standard treatment includes surgical resection followed by chemotherapy and radiation. Recent studies emphasize the genetic differences between cerebellar and supratentorial tumours, with new treatments targetting specific molecular abnormalities. Immunotherapy has shown limited effectiveness due to the unique tumour environment in cHGG, and further research is required to improve treatment strategies for these rare tumours.

This brief communication describes the concept of physiofriendly pharmacotherapy for type 2 diabetes mellitus. Physio-friendly therapy is defined as that which restores metabolic, including glycaemic and weight homoeostasis, to near normal levels. Drugs such as glucagon like peptide 1 receptor agonists (GLP1RA), sodium glucose cotransporter- 2 inhibitors (SGLT2i), and alfa glucosidase inhibitors, along with metformin, work in a physio-friendly manner and may facilitate remission. Thus, they can also be termed as remission-facilitating drugs.

Objective: To compare the complications related to silicone oil, and anatomical and functional outcomes in patients nursed in different postoperative positionings after pars plana vitrectomy with silicone oil injection in retinal surgery.

Methods: The retrospective cohort study was conducted at the Department of Ophthalmology, King AbdulAziz Medical City, Riyadh, Saudi Arabia, and comprised data of patients who underwent pars plana vitrectomy with silicone oil tamponade from January 2016 to October 2022. The patients were divided into two groups depending on how they were nursed in the postoperative period. Group A patients were nursed in postoperative face-down positioning and group B patients were nursed in the face-up position. Complications related to silicone oil tamponade, visual outcomes and anatomical results were compared between the groups. Data was analyzed using SPSS 26.

Results: Of the 157, 97(62%) were males and 60(38%) were females. The overall mean age was 5320 years. Group A had 87(55.4%) patients, while group B had 70(44.6%). There were 185 eyes involved; 104(56.2%) in group A and 81(43.8%) in group B. Overall, mean postoperative follow-up duration was 2519 months. Migration of silicone oil in the anterior chamber was more common in group A (p=0.470). Pupil block glaucoma was seen in 2(1.9%) eyes in group A only.Silicone oil-related complications, functional outcomes and anatomical outcomes were non-significantly different between the grpups (p>0.05) except a weak significant difference with respect to redetachments after removal of silicone oil (p=0.047).

Conclusion: There was no difference seen in terms of complications as well as anatomical and physiological outcomes related to silicone oil tamponade in face-down or face-up postoperative positioning after pars plana vitrectomy with silicone oil tamponade for complicated retinal detachment surgery.

Non-Hodgkin CD30+ T-cell lymphoproliferative disease encompasses three subgroups, one of which is primary cutaneous anaplastic large T-cell lymphoma (PC-ALCL). It is distinguished by the presence of giant anaplastic cells with pleomorphism and widespread CD30 positivity. The case of a 58-year-old female is presented who reported to the Eye Department of Jinnah Post-Graduate Medical Centre (JPMC) on 18th January, 2023 with a three-month history of rapidly enlarging, non-tender, ulcerated lesion on the lower eyelid of the right eye. The histopathology report identified the lesion as CD30+ primary cutaneous anaplastic large cell lymphoma. Computed tomography (CT) scanning of the orbit revealed no extension, and positron emission tomography-computed tomography (PET-CT) showed no systemic involvement. The patient underwent surgical excision without adjuvant chemoradiation and has remained in clinical remission for five months.