Journal of the Pakistan Medical Association最新文献

Cerebral cavernous malformations (CCM) are rare, benign vascular anomalies of the central nervous system with a prevalence of 0.5-0.8%. While often discovered incidentally, they may present with seizures, headaches, focal neurological deficits, or intracranial haemorrhage. Sporadic cases typically involve solitary lesions, whereas familial forms are associated with multiple lesions and genetic mutations such as PDCD10. Supratentorial locations predominate, but brainstem, cerebellar, and spinal involvement are also observed. Management depends on symptomatology and lesion site. Asymptomatic cases are generally observed with serial imaging, while symptomatic lesions may require intervention. Microsurgical resection remains the treatment of choice for patients with medically refractory seizures or recurrent haemorrhage, offering favourable long-term outcomes and high seizure control rates. Radiosurgery may be considered for deep or eloquent lesions where open surgery carries a higher risk, though its benefits are delayed. An individualized approach is essential to optimize neurological and functional outcomes in CCM.

Administration of anaesthesia to patients with severe obesity comes with its own challenges. This has become even more relevant in current day times as the number of people with severe obesity is increasing rapidly. There is a need for all treating doctors, including the referring physician, the anaesthetist, the operating surgeon, and the post-operative intensivist, to understand and counsel about these risks to patients with obesity in the perioperative period. In this paper, the authors highlight the risks associated with anaesthesia in a patient with severe obesity. In addition, the risk assessment and the impact of obesity on the usage of different anaesthetic agents are also highlighted.

Ectopic thyroid tissue results from the embryonic failure of the thyroid gland to descend along the thyroglossal duct, resulting in the presence of thyroid tissue in an abnormal location. One of the most common locations where ectopic thyroid tissue (ETT) is found is at the base of the tongue, referred to as a lingual thyroid, having an estimated prevalence of 1 out of 100,000 to 300,000 in healthy individuals. We present the case of a 15-year-old female with a progressively enlarging mass at the base of her tongue, associated with dysphagia and sleep apnoea. Hormonal tests revealed hypothyroidism. Adopting a transoral approach, total resection was performed via electrocautery. Histopathology report revealed squamous lined tissue exhibiting mucous gland, confirming the diagnosis of ectopic lingual thyroid. The patient was started on thyroxine maintenance therapy and showed significant improvement.

Objective: To evaluate the flexural and impact strength of heat- cured polymethyl methacrylate and vertex resins after disinfection with alkaline peroxide and sodium hypochlorite solution.

Methods: The in-vitro, experimental study was conducted at the Dr Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Karachi, from June 15, 2019, to May 31, 2020, and comprised samples of polymethyl methacrylate and vertex rapid simplified resins that were fabricated using custom metal moulds. The samples were divided into three groups based on the immersion medium: distilled water (control group), alkaline peroxide, and sodium hypochlorite. An immersion time of 6 hours was chosen to simulate one day, thereby three months of continuous immersion represented one year. The samples were then subjected to a 3-point bending test and the Pendulum Impact test to evaluate their flexural and impact strength, respectively. Data was analysed using SPSS 21.

Results: There were 90 samples each of polymethyl methacrylate and vertex rapid simplified resins. There was a significant difference in the mean values of impact strength between polymethyl methacrylate and vertex rapid simplified resins following immersion in the disinfectants (p<0.05). However, no significant difference was observed in flexural strength among the groups subjected to immersions in alkaline peroxide and sodium hypochlorite solutions (p>0.05).

Conclusion: The immersion in denture cleansers led to an enhancement in both flexural and impact strength for vertex resin simplified resins compared to conventional polymethyl methacrylate denture base materials.

Objective: To assess the impact of socioeconomic status on the prevalence of low birth weight babies.

Methods: The cross-sectional study was conducted at the Allied Hospital, Faisalabad, Pakistan, from March 28, 2022, to February 28, 2023, and comprised mothers with low birthweight infants (<2500g). Data included maternal age, residential status, educational status of the parents, prenatal care practices, maternal workload, infection incidence during pregnancy, relevant family history, maternal weight, income level, employment status, and drug usage. Data was analysed using SAS 9.4.

Results: Of the 120 mothers with mean age 30.5±6.1 years, 90(75%) were aged 18-40 years, 78(65%) resided in rural areas, and 82(68%) had lower educational levels. Moreover, 80(67%) mothers did not receive antenatal care, and 44(37%) reported infections during pregnancy. Family history of low birthweight babies was prevalent in 64(53.33%) cases. Maternal weight was normal in 78(65%) cases. The income level was less than Pak Rupee 10,000 in 88(73.33%) cases and there were 90(75%) non-working women. Overall, 81(67.5%) of the infants developed postnatal jaundice.

Conclusions: A complex interplay of socioeconomic factors, including maternal age, family income, occupation, area of residence, education level and antenatal care utilisation, was evident in relation to low birthweight.

Traditionally, chronic complications of diabetes have been classified as microvascular and macrovascular. As our knowledge and understanding of diabetes develops, we increasingly find that conventional classifications and frameworks are unable to encapsulate the wide spectrum of the syndrome. We propose a seven-angled rubric, to serve as a contemporary taxonomic structure for diabetes complications. This includes not only the vascular consequences, but sapio-metabolic, oculo-metabolic, viscero-metabolic, musculoskeletal and repro-metabolic complications of diabetes as well. This taxonomic structure, presented in tabular and hexagonal form, should prove useful for all students of diabetology.