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Comparison of Intermediate and Superficial Cervical Plexus Blocks for Central Venous Catheterisation. 用于中心静脉导管插入术的中层和表层颈丛神经阻滞的比较
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.869
Murat Sevim, Mahmut Sami Tutar, Betul Kozanhan

Objective: To compare the effectiveness of the superficial cervical plexus (SCP) and ultrasonography (USG)-guided intermediate cervical plexus (ICP) blocks for patient and operator satisfaction during central venous catheterisation (CVC).

Study design: Experimental study. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Konya City Hospital, Konya, Turkiye, between May and July 2022.

Methodology: Eighty patients were randomly assigned to the ICP and SCP block groups before CVC. Patients received 10ml of a local anaesthesia. Pain levels were assessed during needle insertion, dilation, catheter insertion, and suturing, and 5 minutes after the procedure using a 10-point numeric rating scale (NRS). Thirty minutes post-procedure, patient and operator satisfaction were evaluated using a 5-point Likert-type scale.

Results: The ICP block group had lower mean pain scores than the SCP block group during needle entry, dilation, and 5 minutes after CVC (p = 0.022, p <0.001, and p = 0.005, respectively). However, no significant differences were found in pain scores after the block application, during catheter insertion, and suturing (p = 0.279, p = 0.052, and p = 0.072, respectively). Patient and operator satisfaction scores did not significantly differ between the two groups (p = 0.189 and p = 0.329, respectively).

Conclusion: The study demonstrated that the ICP and SCP blocks resulted in comparable patient and operator satisfaction levels during CVC. Given that the ICP block resulted in lower pain scores at various stages of the procedure, it is a recommended method to enhance overall patient comfort and minimise the pain during CVC.

Key words: Central venous catheterisation, Intermediate cervical plexus block, Superficial cervical plexus block, Patient satisfaction.

目的比较浅层颈丛(SCP)和超声波(USG)引导的中层颈丛(ICP)阻滞对中心静脉导管插入术(CVC)中患者和操作者满意度的影响:实验研究。研究地点和时间:2022年5月至7月,土耳其科尼亚市科尼亚市医院麻醉与复苏科:80 名患者在 CVC 前被随机分配到 ICP 和 SCP 阻滞组。患者接受 10 毫升的局部麻醉。使用 10 点数字评分量表(NRS)评估插针、扩张、导管插入和缝合时以及术后 5 分钟的疼痛程度。术后 30 分钟,使用 5 点李克特量表对患者和操作者的满意度进行评估:结果:在进针、扩张和 CVC 术后 5 分钟内,ICP 阻断组的平均疼痛评分低于 SCP 阻断组(p = 0.022,p 结论:ICP 和 SCP 阻断组的平均疼痛评分均低于 SCP 阻断组:研究结果表明,ICP 和 SCP 阻滞在 CVC 过程中给患者和操作者带来的满意度相当。鉴于 ICP 阻滞在手术的各个阶段都会导致较低的疼痛评分,因此建议采用这种方法来提高患者的整体舒适度,并将 CVC 过程中的疼痛降至最低:中心静脉导管术 颈丛神经中段阻滞 颈丛神经浅层阻滞 患者满意度
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引用次数: 0
Histological Findings in Antigen E Positive and Negative in Chronic Hepatitis B. 慢性乙型肝炎 E 抗原阳性和阴性患者的组织学检查结果
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.891
Mustafa Zanyar Akkuzu, Berat Ebik, Ferhat Bacaksiz, Ali Uzel, Ahmet Yavuz, Umit Karabulut

Objective: To determine the histopathological findings in patients with HBeAg-positive chronic HBV infection (immunotolerant phase in old terminology) and HBeAg-negative chronic HBV infection (inactive carrier phase in old terminology).

Study design: Observational study. Place and Duration of the Study: Department of Gastroenterology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkiye and Diyarbakir and Mersin University School of Medicine, Diyarbakir, Turkiye, from May 2014 to August 2022.

Methodology: The difference between fibrosis and histological activity indices of 289 patients in the immunotolerant and inactive carrier phase who had liver biopsy was examined statistically. Additionally, the relationship of these data with age and gender was investigated.

Results: While 236 (81.7%) of the patients were in the inactive carrier phase, 53 (18.3%) patients were in the immunotolerant phase. The mean fibrosis score of patients in the immunotolerant stage was 2.0 ± 1.2, while it was 2.0 ± 1.0 in inactive carriers (p = 0.753). The number of patients with a fibrosis score of two and above was 21 (39.6%) in immunotolerant patients and 52 (22.0%) in inactive carrier patients (p = 0.004). In patients under 30 years of age, the mean fibrosis score was 1.7 ± 1.0. It was 2.0 ± 1.1 in those over 30 years of age (p = 0.016).

Conclusion: Biochemical parameters or viral load cannot clearly reflect cellular damage in the liver. In the future, HBV DNA positivity alone may be the only criterion for the treatment.

Key words: Chronic viral hepatitis B, Fibrosis, Immune tolerance phase, Inactive carrier phase.

目的确定 HBeAg 阳性慢性 HBV 感染(旧称免疫耐受期)和 HBeAg 阴性慢性 HBV 感染(旧称非活动携带期)患者的组织病理学结果:研究设计:观察性研究。研究地点和时间:2014年5月至2022年8月,土耳其迪亚巴克尔,迪亚巴克尔加齐-亚萨吉尔教育和研究医院,迪亚巴克尔卫生科学大学,消化内科;土耳其迪亚巴克尔,迪亚巴克尔和梅尔辛大学医学院:对 289 名接受肝活检的免疫耐受期和非活动携带期患者的肝纤维化指数和组织学活动指数之间的差异进行统计分析。此外,还研究了这些数据与年龄和性别的关系:结果:236 名患者(81.7%)处于非活动携带期,53 名患者(18.3%)处于免疫耐受期。免疫耐受期患者的平均纤维化评分为(2.0 ± 1.2)分,而非活动携带者的平均纤维化评分为(2.0 ± 1.0)分(p = 0.753)。在免疫耐受期患者中,纤维化评分达到 2 分及以上的患者人数为 21 人(39.6%),非活动携带者患者为 52 人(22.0%)(p = 0.004)。在 30 岁以下的患者中,平均纤维化评分为 1.7 ± 1.0。结论:结论:生化指标或病毒载量不能明确反映肝脏的细胞损伤。结论:生化指标或病毒载量不能明确反映肝脏的细胞损伤,未来,HBV DNA 阳性可能是治疗的唯一标准:慢性乙型病毒性肝炎 纤维化 免疫耐受期 非活动载体期
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引用次数: 0
Outcomes of Low-Risk Differentiated Thyroid Cancer (DTC) without Radioactive Iodine (RAI) Ablation Therapy Post-Thyroidectomy: An Experience from a Tertiary Centre in Karachi. 甲状腺切除术后未经放射性碘 (RAI) 消融治疗的低风险分化型甲状腺癌 (DTC) 的疗效:卡拉奇一家三级医疗中心的经验。
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.968
Nazish Fatima, Zareen Kiran, Javaid Iqbal, Akhtar Ali Baloch, S M Salman Habib, Akhtar Ahmed

Objective: To assess the outcomes of low-risk differentiated thyroid cancer (DTC) with tumour size 1 to 4 cm post-thyroidectomy in patients who never received radioactive iodine (RAI) ablation and to compare the outcomes with those who received RAI therapy.

Study design: Observational study. Place and Duration of the Study: Department of Nuclear Medicine, Karachi Institute of Radiotherapy and Nuclear Medicine (KIRAN) Hospital, Karachi, Pakistan, from January 2016 to December 2020.

Methodology: A total of 130 consecutive patients of low-risk DTC of both genders aged between 18-75 years were identified who underwent thyroidectomy. Patients were classified as either being treated or not treated with RAI, based on RAI data post-thyroidectomy. Patients were followed up for two to five years depending on their date of diagnosis from 2016 to 2020, using thyroglobulin (Tg), anti-thyroglobulin (anti-Tg), and thyrotropin (TSH) levels and ultrasound neck. Association between patients who received RAI and who did not receive RAI was determined and a p-value <0.05 was considered as statistical significance.

Results: Patients had mean age of 34.5 ± 10.4 years with majority of females (75.4%). Majority of the patients (94.6%) had total thyroidectomy with no neck dissection (83.1%). RAI therapy was conducted among 70.8% participants, of which, 56.9% participants received a dose of 100 mci. Most of the patients had positive outcomes as there was no recurrence among 96.2% participants. There was a significant difference in RAI therapy with total thyroidectomy as compared to subtotal, RAI dose, tumour stage, neck dissection, and lymph node involvement (p ≤0.001).

Conclusion: After complete tumour resection, a highly selected group of patients with low-risk local disease have shown low rate of recurrence when managed without RAI. Interestingly, the disease recurrence was also only seen in patients who received RAI therapy in comparison to those who did not receive RAI therapy.

Key words: Outcomes, Differentiated thyroid cancer, Radioactive iodine, Ablation therapy, Post-surgery.

目的评估甲状腺切除术后肿瘤大小为1至4厘米的低危分化型甲状腺癌(DTC)患者中从未接受过放射性碘(RAI)消融治疗者的预后,并与接受过RAI治疗者的预后进行比较:观察性研究。研究地点和时间:巴基斯坦卡拉奇放疗与核医学研究所(KIRAN)医院核医学科,2016年1月至2020年12月:共确定了 130 名接受甲状腺切除术的低风险 DTC 连续患者,男女患者年龄均在 18-75 岁之间。根据甲状腺切除术后的 RAI 数据,将患者分为接受 RAI 治疗和未接受 RAI 治疗两类。从2016年到2020年,根据患者的诊断日期,采用甲状腺球蛋白(Tg)、抗甲状腺球蛋白(anti-Tg)、促甲状腺激素(TSH)水平和颈部超声波对患者进行了2到5年的随访。确定接受 RAI 和未接受 RAI 的患者之间的关联,并得出 p 值 结果:患者平均年龄为(34.5 ± 10.4)岁,女性占多数(75.4%)。大多数患者(94.6%)接受了全甲状腺切除术,其中 83.1%未进行颈部切除。70.8%的患者接受了 RAI 治疗,其中 56.9% 的患者接受了 100 mci 的剂量。大多数患者的治疗效果良好,96.2%的患者没有复发。甲状腺全切除术与次全切除术的 RAI 治疗、RAI 剂量、肿瘤分期、颈部切除术和淋巴结受累情况相比均有显著差异(P ≤0.001):完全切除肿瘤后,经过严格筛选的低风险局部疾病患者在不使用 RAI 的情况下复发率较低。有趣的是,与未接受 RAI 治疗的患者相比,只有接受 RAI 治疗的患者才会出现疾病复发:结果 分化性甲状腺癌 放射性碘 消融治疗 手术后
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引用次数: 0
Genetic Analysis of Potential Biomarkers and Therapeutic Targets in Ferroptosis from Steroid-Induced Osteonecrosis of the Femoral Head Based on Machine Learning. 基于机器学习的类固醇诱导的股骨头骨坏死潜在生物标志物和治疗靶点的遗传分析
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.916
Jun Zhao, Junjie Guan, Xingshi Zhang, Jizhao Jiang, Kun Dou

Objective: To locate the candidate therapeutic target genes involved in ferroptosis in steroid-induced osteonecrosis of the femoral head (SONFH).

Study design: Bioinformatics analysis study. Place and Duration of the Study: Department of Orthopaedic Surgery, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong, China, from March to July 2023.

Methodology: After processing the gene expression omnibus (GEO) data with the R programming language, differentially expressed ferroptosis-related genes in SONFH were identified. To pinpoint the genes most strongly linked to SONFH in association with ferroptosis, least absolute shrinkage and selection operator (LASSO) regression and support vector machine-recursive feature elimination (SVM-RFE) were employed. Subsequently, the screened essential genes were analysed to investigate immune cell infiltration, and competing endogenous RNA (ceRNA) networks involving these marker genes were constructed.

Results: The machine learning algorithms identified three genes i.e., SOCS1 (suppressor of cytokine signalling1), MYCN (N-myc proto-oncogene protein), and KLF2 (Kruppel-like factor 2) as diagnostic feature biomarkers associated with ferroptosis. Additionally, CIBERSORT analysis revealed that alterations in the immune microenvironment, such as Macrophages M1, Monocytes, and T cells CD4 naive, could be linked to SOCS1, MYCN, and KLF2. Moreover, the competing endogenous RNA (ceRNA) network exposed a complex regulatory relationship based on marker genes.

Conclusion: SOCS1, MYCN, and KLF2 are potential biomarkers associated with ferroptosis in SONFH, pending confirmation in future studies.

Key words: Steroid-induced osteonecrosis of the femoral head, Ferroptosis, Machine learning, Genetic analysis.

研究目的研究设计:研究设计:生物信息学分析研究。研究地点和时间研究地点和时间:中国广东省珠海市中西医结合医院骨科,2023年3月至7月:用R语言处理基因表达总库(GEO)数据后,确定SONFH中与铁突变相关的差异表达基因。为了找出与 SONFH 铁病关联最密切的基因,采用了最小绝对收缩和选择算子(LASSO)回归和支持向量机-递归特征消除(SVM-RFE)。随后,对筛选出的重要基因进行了分析,以研究免疫细胞浸润,并构建了涉及这些标记基因的竞争内源性 RNA(ceRNA)网络:结果:机器学习算法确定了三个基因,即 SOCS1(细胞因子信号抑制因子 1)、MYCN(N-myc 原癌基因蛋白)和 KLF2(Kruppel 样因子 2),作为与铁蛋白沉着症相关的诊断特征生物标志物。此外,CIBERSORT分析显示,免疫微环境的改变,如巨噬细胞M1、单核细胞和CD4幼稚T细胞,可能与SOCS1、MYCN和KLF2有关。此外,竞争性内源性 RNA(ceRNA)网络揭示了基于标记基因的复杂调控关系:结论:SOCS1、MYCN 和 KLF2 是与 SONFH 中铁细胞凋亡相关的潜在生物标志物,有待未来研究证实:类固醇诱导的股骨头坏死 铁沉积 机器学习 遗传分析
{"title":"Genetic Analysis of Potential Biomarkers and Therapeutic Targets in Ferroptosis from Steroid-Induced Osteonecrosis of the Femoral Head Based on Machine Learning.","authors":"Jun Zhao, Junjie Guan, Xingshi Zhang, Jizhao Jiang, Kun Dou","doi":"10.29271/jcpsp.2024.08.916","DOIUrl":"https://doi.org/10.29271/jcpsp.2024.08.916","url":null,"abstract":"<p><strong>Objective: </strong>To locate the candidate therapeutic target genes involved in ferroptosis in steroid-induced osteonecrosis of the femoral head (SONFH).</p><p><strong>Study design: </strong>Bioinformatics analysis study. Place and Duration of the Study: Department of Orthopaedic Surgery, Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine, Guangdong, China, from March to July 2023.</p><p><strong>Methodology: </strong>After processing the gene expression omnibus (GEO) data with the R programming language, differentially expressed ferroptosis-related genes in SONFH were identified. To pinpoint the genes most strongly linked to SONFH in association with ferroptosis, least absolute shrinkage and selection operator (LASSO) regression and support vector machine-recursive feature elimination (SVM-RFE) were employed. Subsequently, the screened essential genes were analysed to investigate immune cell infiltration, and competing endogenous RNA (ceRNA) networks involving these marker genes were constructed.</p><p><strong>Results: </strong>The machine learning algorithms identified three genes i.e., SOCS1 (suppressor of cytokine signalling1), MYCN (N-myc proto-oncogene protein), and KLF2 (Kruppel-like factor 2) as diagnostic feature biomarkers associated with ferroptosis. Additionally, CIBERSORT analysis revealed that alterations in the immune microenvironment, such as Macrophages M1, Monocytes, and T cells CD4 naive, could be linked to SOCS1, MYCN, and KLF2. Moreover, the competing endogenous RNA (ceRNA) network exposed a complex regulatory relationship based on marker genes.</p><p><strong>Conclusion: </strong>SOCS1, MYCN, and KLF2 are potential biomarkers associated with ferroptosis in SONFH, pending confirmation in future studies.</p><p><strong>Key words: </strong>Steroid-induced osteonecrosis of the femoral head, Ferroptosis, Machine learning, Genetic analysis.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 8","pages":"916-921"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141904075","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
Acute Kidney Injury in COVID-19 Pneumonia Patients Admitted to the Intensive Care Unit. 入住重症监护室的 COVID-19 肺炎患者的急性肾损伤。
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.993
Isil Kose Guldogan, Yakup Ozgungor, Aysen Evkan Ozturk, Sibel Ersan, Kazim Rollas

This retrospective study was conducted at the Izmir Tepecik Training and Research Hospital from January 2020 to December 2021. It aimed to determine acute kidney injury (AKI) frequency and associated factors in critically ill COVID-19 patients. Out of 177 patients, 49.7% developed AKI, with an average onset of 7.63 days. AKI stages varied, and progression occurred in 27 patients within 48 hours. ICU and hospital mortality rates were significantly higher in AKI patients (86.4% and 92%, respectively) compared to non-AKI patients (19.1% and 22.5%). The study highlights age, sequential organ failure assessment (SOFA) score, and nephrotoxic agent presence as significant factors influencing AKI development in COVID-19 patients. Key Words: Critical care unit, COVID-19, Acute kidney failure.

这项回顾性研究于 2020 年 1 月至 2021 年 12 月在伊兹密尔特佩契克培训与研究医院进行。研究旨在确定 COVID-19 重症患者急性肾损伤(AKI)的发生频率和相关因素。在177名患者中,49.7%出现了AKI,平均发病时间为7.63天。AKI 阶段各不相同,27 名患者在 48 小时内病情恶化。与非 AKI 患者(19.1% 和 22.5%)相比,AKI 患者的重症监护室死亡率和住院死亡率明显更高(分别为 86.4% 和 92%)。研究强调,年龄、序贯器官衰竭评估(SOFA)评分和肾毒性药物的存在是影响 COVID-19 患者发生 AKI 的重要因素。关键字重症监护病房 COVID-19 急性肾衰竭
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引用次数: 0
Screening for Early Biomarkers of Cisplatin-Induced Acute Kidney Injury in Rats Through Serum Metabolomics Technology. 通过血清代谢组学技术筛选顺铂诱发大鼠急性肾损伤的早期生物标志物
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.936
Jinru Yang, Mingkang Zhang, Fenglin Ran, Xueyan Gou, Yanrong Ma, Xinan Wu

Objective: To systematically identify early biomarkers of cisplatin-induced acute kidney injury (AKI) in rats.

Study design: An experimental study. Place and Duration of the Study: Experimental Animal Laboratory of Lanzhou University, Gansu, China, and the Department of Pharmacy, The First Hospital of Lanzhou University, Gansu, China, from July 2022 to October 2023.

Methodology: In this study, an AKI model was established by continuously injecting cisplatin into rats at a dose of 1 mg/kg once a day for control group and for 2, 3, 4, and 5 days to other four groups, respectively. Subsequently, rat plasma samples were collected for metabolomics analysis to identify early differentiated metabolites in the plasma prior to creatinine elevation. Furthermore, accurate HPLC-MS/MS methods were developed to validate the biomarker variation in other AKI models.

Results: The occurrence of time-dependent renal cortical injury and significant alterations of creatinine (Cr) concentration were observed on day-4 and 5, which demonstrated successful model construction. Sixty-six compounds changed on Day-2 while 61 compounds changed on Day-3. Eleven compounds with variable importance in projection (VIP) >1.5 and false discover rate (FDR) <0.2 were selected and identified by HPLC-MS/MS. Among these, N-acetylglutamine and citramalic acid changed earlier than serum creatinine (sCr) in the AKI model.

Conclusion: N-acetylglutamine and citramalic acid may serve as early biomarker of cisplatin-induced AKI.

Key words: Acute kidney injury, Biomarker, Cisplatin, Metabolomics, LC-MS/MS, Rats.

研究目的系统鉴定顺铂诱导大鼠急性肾损伤(AKI)的早期生物标志物:实验研究。研究地点和时间研究地点:中国甘肃兰州大学实验动物实验室和中国甘肃兰州大学第一医院药学部,时间:2022年7月至2023年10月:本研究通过给大鼠连续注射顺铂建立AKI模型,对照组剂量为每天1毫克/千克,其他四组剂量分别为2天、3天、4天和5天。随后,采集大鼠血浆样本进行代谢组学分析,以确定血浆中肌酐升高前的早期分化代谢物。此外,还开发了精确的 HPLC-MS/MS 方法,以验证生物标记物在其他 AKI 模型中的变化:结果:第 4 天和第 5 天观察到了时间依赖性肾皮质损伤的发生和肌酐(Cr)浓度的显著变化,这表明模型的构建是成功的。第 2 天有 66 种化合物发生了变化,第 3 天有 61 种化合物发生了变化。有 11 种化合物的预测重要性(VIP)大于 1.5,错误发现率(FDR)为结论:N-乙酰谷氨酰胺和柠檬醛酸可作为顺铂诱导的急性肾损伤的早期生物标志物:急性肾损伤 生物标志物 顺铂 代谢组学 LC-MS/MS 大鼠
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引用次数: 0
The Impact of Nusinersen and Risdiplam on Motor Function for Spinal Muscular Atrophy Type 2 and 3: A Meta-Analysis. 2型和3型脊髓性肌肉萎缩症患者服用纽西奈森和利迪普兰对运动功能的影响:一项 Meta 分析。
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.948
Bo Chen, Yuanlin Gong, Tengteng Zhou

Spinal muscular atrophy (SMA) is a prevalent paediatric neuromuscular disorder characterised by muscle weakness and atrophy resulting from degeneration of spinal cord anterior horn α motor neurons. Gene therapy formulations exhibit varying benefits and limitations, driving the need for patient-friendly treatment options tailored to specific populations. The objective of this meta-analysis was to assess the effectiveness of gene therapy for motor function in children with SMA. The analysis encompassed a total of 719 participants from six randomised controlled trials (RCTs) conducted between 2017 and 2023. Among the studies, one demonstrated a significant and large standardised effect size (Cohen's d) favouring nusinersen in terms of Hammersmith Functional Motor Scale - Expanded (HFMSE) (d = 0.97) and revised upper limb module (RULM) (d = 0.96). Additionally, another study showed a moderate standardised effect size (Cohen's d) in favour of nusinersen concerning Hammersmith Infant Neurological Examination-Section 2 (HINE-2) (d = 0.48). However, it is important to note that further research with a longer duration of observation is required to strengthen the evidence. Key Words: Spinal muscular atrophy, Nusinersen, Risdiplam, Motor function, Cohen's d.

脊髓性肌萎缩症(SMA)是一种常见的儿科神经肌肉疾病,其特点是脊髓前角α运动神经元变性导致肌肉无力和萎缩。基因治疗配方表现出不同的优势和局限性,因此需要为特定人群量身定制适合患者的治疗方案。本荟萃分析旨在评估基因疗法对 SMA 儿童运动功能的有效性。分析涵盖了2017年至2023年间进行的六项随机对照试验(RCT)中的719名参与者。在这些研究中,有一项研究显示,在哈默史密斯功能性运动量表--扩展版(HFMSE)(d = 0.97)和修订版上肢模块(RULM)(d = 0.96)方面,纽西奈森具有显著且较大的标准化效应大小(Cohen's d)。此外,另一项研究显示,在哈默史密斯婴儿神经系统检查第 2 部分(HINE-2)(d = 0.48)方面,纽西奈森的标准化效应大小(Cohen's d)为中等。不过,需要注意的是,还需要进行更长时间的观察研究,以加强证据。关键字脊髓性肌肉萎缩症 努西能森、利迪普兰、运动功能、Cohen's d。
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引用次数: 0
Surgical Interventions for Acute Limb Ischaemia (ALI). 急性肢体缺血(ALI)的外科干预。
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.985
Zia Ur Rehman, Faisal Sher, Mohammad Hamza Bajwa

Objective: To evaluate presentations, aetiologies, interventions, and outcomes of patients presenting with acute limb ischaemia (ALI).

Study design: An observational study. Place and Duration of the Study: Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan, from January 2000 to December 2020.

Methodology: Record of 104 patients who underwent surgical interventions for ALI was retrospectively evaluated. The diagnosis was confirmed on imaging (ultrasound / CTA / conventional angiography). Demographic characteristics, co-morbidities, aetiologies, and outcomes were analysed using descriptive statistics and logistic regression.

Results: The cohort's mean age was 58.89 ± 12.6 years, with (54.8%, n = 57) females and (45.2%, n = 47) males. Hypertension (54.8%, n = 57), diabetes (46.2%, n = 48), and atrial fibrillation (34.6%, n = 36) were common comorbidities. Thromboembolism (67.3%, n = 70) and thrombotic occlusion (32.7%, n = 34) were primary aetiologies, predominantly affecting the lower limb (66.3%, n = 58) and femoral artery (51.9%, n = 54). The majority of cases were classified as Rutherford classification 2A (53.8%; 56 cases) and 2B (44.2%; 46 cases); 58 (55.8%) patients were classified as ASA Class III, while 36 (34.6%) patients were categorised as ASA Class IV. Embolectomy (80.8%, n = 84) was the prevailing intervention, with an amputation rate (17.3%, n = 18) and a mortality rate (5.8%, n = 6).

Conclusion: Most patients with ALI presented with Rutherford Class II and had thromboembolism aetiology. Embolectomy was the most commonly performed procedure with a high amputation rate and mortality.

Key words: Acute limb ischaemia, Embolectomy, Amputation, Thromboembolism.

研究目的评估急性肢体缺血(ALI)患者的表现、病因、干预措施和治疗效果:观察性研究。研究地点和时间:巴基斯坦卡拉奇阿迦汗大学医院外科,2000 年 1 月至 2020 年 12 月:方法:回顾性评估104例因ALI接受手术治疗的患者的记录。诊断由影像学(超声/CTA/常规血管造影)证实。采用描述性统计和逻辑回归分析了人口统计学特征、并发症、病因和结果:患者平均年龄为(58.89 ± 12.6)岁,其中女性(54.8%,n = 57),男性(45.2%,n = 47)。高血压(54.8%,n = 57)、糖尿病(46.2%,n = 48)和心房颤动(34.6%,n = 36)是常见的合并症。血栓栓塞(67.3%,n = 70)和血栓闭塞(32.7%,n = 34)是主要病因,主要影响下肢(66.3%,n = 58)和股动脉(51.9%,n = 54)。大多数病例被归类为卢瑟福分类 2A(53.8%;56 例)和 2B(44.2%;46 例);58 例(55.8%)患者被归类为 ASA III 级,36 例(34.6%)患者被归类为 ASA IV 级。栓子切除术(80.8%,n = 84)是最主要的干预措施,截肢率(17.3%,n = 18)和死亡率(5.8%,n = 6):结论:大多数 ALI 患者为卢瑟福 II 级,病因为血栓栓塞。栓塞切除术是最常见的手术,截肢率和死亡率都很高:急性肢体缺血、栓塞切除术、截肢、血栓栓塞。
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引用次数: 0
--------Comparison of Hybrid-Simulation-Based Teaching with Traditional Teaching of Pharmacology. -------- 基于混合模拟的药理学教学与传统教学的比较。
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.963
Samia Perwaiz Khan, Ambreen Usmani, Ambareen Khan

Objective: To compare the outcome of traditional teaching with hybrid simulation-based teaching for undergraduate medical students. Place and Duration of the Study: Department of Pharmacology, Jinnah Medical and Dental College, Karachi, Pakistan, from June to August 2023.

Study design: Quasi-experimental study.

Methodology: One hundred students from MBBS 3rd year were included in the study after taking the informed consent. Participants were divided into two cross-over groups and sampling was done randomly. Group A: (even roll numbers, n = 50) was the control group, taught by traditional lecture on positive inotropic medicines. Group B: (with odd roll numbers, n = 50) was the intervention group, taught the same topic by simulation-based teaching through 5 case scenarios. The teaching of this group was reinforced by role plays. Scores of post-test and retention test were compared by applying the Student's t-test.

Results: Students taught by traditional lectures i.e., Group A, their post-test mean scores were 30.7 ± 5.6, whereas Group B scored 45.7 ± 3.3, taught by hybrid stimulation (p <0.001). Retention test (MCQs based) was conducted after one month in which Group A obtained a mean score of 18.8 ± 9 with a passing percentage of approximately 30, whereas Group B obtained a score of 41.3 ± 5.6 (p <0.001).

Conclusion: Hybrid-simulation-based teaching improved the immediate test scores as well as retention.

Key words: Traditional teaching, Hybrid-simulation, MCQs, Retention test, Intervention group.

目的比较医学本科生传统教学与混合模拟教学的效果。研究地点和时间:研究设计:准实验研究:研究方法:准实验研究:在获得知情同意后,100 名 MBBS 三年级学生被纳入研究。参与者分为两个交叉组,随机抽样。A 组:(偶数,n = 50)为对照组,以传统方式讲授正性肌力药物。B 组:(奇数,n = 50)为干预组,通过 5 个案例情景进行模拟教学。该组的教学通过角色扮演得到加强。通过学生 t 检验比较了后测和保留率测试的得分:结果:采用传统授课方式的 A 组学生,其后测平均得分为(30.7 ± 5.6)分,而采用混合刺激授课方式的 B 组学生,其后测平均得分为(45.7 ± 3.3)分:基于混合模拟的教学提高了学生的即时考试成绩和保持率:传统教学 混合模拟 MCQs 保留率测试 干预组
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引用次数: 0
Integrating Trauma-Informed Clinical Interviewing Skills in Medical Education for Screening Domestic Violence and Abuse. 在医学教育中融入创伤知情临床访谈技能,以筛查家庭暴力和虐待行为。
Pub Date : 2024-08-01 DOI: 10.29271/jcpsp.2024.08.996
Nargis Asad, Shahina Pirani, Sonia Sameen, Jawed Akbar Dars, Tania Nadeem

A pre-post-training workshop was conducted among 22 postgraduate trainees of the Psychiatry and Emergency Department of a public sector hospital in Karachi. The workshop aimed to build the capacity of postgraduate trainees in trauma management by providing training on screening, clinical interviewing skills, and Psychological first aid to those exposed to domestic violence (DV). The effectiveness of each training module was evaluated by conducting a brief assessment before and after each module and scores were compared using the Wilcoxon signed-rank test. The post-test showed significant improvement in participants' knowledge on screening of domestic violence and trauma symptoms (p = 0.026) and psychological first aid (p <0.001). Postgraduate training programmes need to integrate trauma screening and management education, to prepare healthcare professionals to deal with sensitive clinical presentations at their work settings. Key Words: Postgraduate trainees, Trauma, Domestic violence, Medical education, Workshop.

卡拉奇一家公立医院精神科和急诊科的 22 名研究生学员参加了岗前培训讲习班。讲习班旨在通过为遭受家庭暴力(DV)的人员提供筛查、临床问诊技能和心理急救方面的培训,提高研究生学员的创伤管理能力。通过在每个培训模块前后进行简短评估,对每个培训模块的效果进行评估,并使用 Wilcoxon 符号秩检验对得分进行比较。后测结果显示,参与者对家庭暴力筛查和创伤症状(p = 0.026)以及心理急救(p = 0.026)的认识有了明显提高。
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引用次数: 0
期刊
Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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