Journal of the College of Physicians and Surgeons--Pakistan : JCPSP最新文献

Null.

Objective: To determine the association of HLA-B51/5 in patients of Behcet's disease (BD) in local symptomatic patients.

Study design:  A cross-sectional study. Place and Duration of the Study: Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from August 2020 to July 2023.

Methodology: Blood samples of 100 study participants, including 50 symptomatic patients of BD and 50 disease-free individuals (healthy controls), were taken. DNA was extracted and amplified using sequence-specific primers. Electrophoresis was conducted on 2% agarose gel to separate the DNA. The presence of HLA-B51/5 alleles was determined by analysing the unique band patterns visible on the gel under the ultraviolet light. Descriptive statistics were shown as mean ± SD. Chi-square test was employed to find any significant association between HLA-B51/5 and the disease group and its severity sub-groups. A p-value of less than 0.05 was deemed significant.

Results: The majority of participants, 73 (73%), were females and 27 (27%) were males, with a mean age of 26.84 ± 5.31 years. HLA-B51/5 was positive in 33 of the BD patients (66.0%, <0.001) and 4 of the healthy controls (8.0%). There was no significant difference in HLA-B51 among mild, moderate, and severe BD sub-groups.

Conclusion: HLA-B51/5 is strongly associated with BD in local population and serves as a useful tool for diagnosis of BD. However, it is not associated with the disease severity.

Key words: Agarose gel, Behcet's disease, Electrophoresis, HLA-B51/5 allele, ICBD criteria.

Objective: To determine the clinical efficacy of monosialotetrahexosylganglioside (GM1) combined with methylprednisolone in the treatment of spinal cord injury (SCI).

Study design: An observational study. Place and Duration of the Study: Department of Orthopaedics, Baoding No.1 Central Hospital, Baoding, Hebei, China, from January 2018 to June 2021.

Methodology: A total of 80 patients with SCI were divided into control and observation groups according to treatment methods, the control group receiving methylprednisolone treatment and the observation group receiving methylprednisolone combined with GM1. The effective rate of treatment, time of normal muscle strength recovery, walk on the ground, and hospital stay were compared. The changes in the American Spinal Injury Association (ASIA) score, activity of daily living (ADL), serum inflammatory factors, oxidative stress factor levels, and adverse reactions were recorded.

Results: The effective rate of clinical efficacy of the observation group was 92.50%, surpassing the control group's which was 75.00% (χ2 = 4.501, p = 0.034). The observation group had a shorter recovery time for muscle strength, walking time, and hospital stay compared to the control group (p <0.05). After treatment, the ADL scores of both groups were higher than before treatment, and the degree of increase in the observation group was higher than the control group (p <0.05). The levels of serum tumour necrosis factor-α (TNF-α) and interleukin-8 (IL-8) for all patients were significantly reduced, with the observation group showing a more significant decrease (p <0.05). There was a notable increase in glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) levels in both groups, while the levels of malondialdehyde (MDA) decreased significantly. GSH-Px, SOD, and MDA levels were significantly greater in the observation group (p <0.05).

Conclusion: The combination of methylprednisolone and MG1 treatment of SCI can significantly reduce the inflammatory response and improve clinical efficacy.

Key words: Spinal cord injury, Ganglioside, Methylprednisolone, Inflammatory indicators, Oxidative stress.

Objective: To determine the correlation of serum dehydroepiandrosterone sulphate and anti-mullerian hormone levels with infertility in females.

Study design: Cross-sectional study. Place and Duration of the Study: Department of Chemical Pathology, the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from July 2022 to August 2023.

Methodology: About 110 infertile females with infertility were enrolled in this study. Serum thyroid-stimulating hormone, luteinising hormone, testosterone, follicle-stimulating hormone (FSH), estradiol, serum Anti-Mullerian Hormone (AMH), and Dehydroepiandrosterone Sulphate (DHEA-S) were measured at 3rd menstruation day. Females with primary ovarian insufficiency, using androgen supplementation, and on hormonal therapy were excluded.

Results: Among the participants, 63.6% had primary infertility and 36.4% had secondary infertility. Both primary and secondary infertility had a positive correlation with serum AMH and DHEA-S levels (r = 0.685; p <0.001) and (r = 0.807; p <0.001), respectively. After ultrasound, 54 (49.1%) females were normal, 12 (10.9%) had PCOS, 12 (10.9%) had fibroids, 8 (7.3%) had fallopian tube defects, 10 (9.1%) had endometriosis, and 14 (12.7%) had low antral follicular count. The correlation between serum AMH and DHEA-S with different subgroups is as follows: Normal females (r = 0.731; p <0.001), PCOs (r = -0.232; p = 0.468), fibroids (r = 0.941, p <0.001), fallopian tube defects (r =-0.800; p = 0.017), endometriosis (r = -0.684, p = 0.013), and low antral follicular count (r = 0.643, p = 0.0130).

Conclusion: This study demonstrated a positive correlation between serum AMH and DHEA-S levels in infertile females.

Key words: Infertile women, Ovarian reserve, Anti-Mullerian Hormone, Dehydroepiandrosterone sulphate.

Objective: To evaluate the causal relationship between 1,400 metabolites and colorectal and gastric cancer.

Study design: Mendelian randomisation study. Place and Duration of the Study: The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China, from July to August 2024.

Methodology: Metabolite genome-wide association study (GWAS) data and genetic data from the Canadian Longitudinal Study on Aging (CLSA) as well as the expensive FinnGen project, respectively, were sourced. Suitable instrumental variables were chosen based on their association with metabolites at a genome-wide significance level, thus ensuring a high degree of reliability in the causal inferences drawn. Inverse variance weighting (IVW) was used for initial analysis. Sensitivity analyses were conducted using MR Egger regression and weighted median methods to validate findings and assess potential pleiotropy or bias.

Results: Metabolites were included in the study of 8,299 individuals. Gastric cancer included 1,307 cases and 287,137 controls; while colorectal cancer included 6,509 cases and 287,137 controls. The research identified sixty-nine metabolites associated with varying degrees of risk enhancement or mitigation. For gastric cancer, a more focused discovery highlighted two metabolites with significant causal links-associated with increased risk as well as a protective effect. Sensitivity analyses confirmed the validity of these findings.

Conclusion: By elucidating specific metabolites that exert direct causal effects on colorectal and gastric cancer risk, the study marked a significant advancement in the understanding of the metabolic pathways involved in cancer development.

Key words: Mendelian randomisation, Colorectal cancer, Gastric cancer, Metabolites, Genetic variants, Genome-wide association studies, Causal inference.

Null.

Null.

The aim of this study was to assess patient satisfaction and pain relief before and after interventions for chronic pain in a tertiary care pain clinic. It was a cross-sectional study, carried out in the Anaesthesia, Pain, and Intensive Care Department of the Combined Military Hospital, Rawalpindi, Pakistan, from January to July 2021. The patients were included in the study after obtaining an Ethical Committee Certificate and informed consents from the patients. The pain scores and patient satisfaction were measured before the procedure and after the procedure and comparisons were drawn with the help of Chi-square analysis with significance at less than 0.05. The mean visual analogue score recorded in the patients before the procedure was 8.9 ± 0.846. The mean visual analogue score (VAS) recorded after the procedure was 1.56 ± 1.328 at 10 minutes, 1.77 ± 1.535 at day three, and 3.13 ± 1.522 at three months with p-value of 0.28, 0.20, and 0.007, respectively. The patient satisfaction was 84.19 ± 13.89% at 10 minutes post-procedure, 83.08 ± 14.82% after three days, and 70.79 ± 44.5% after three months. Pain interventions provided reliable and satisfactory analgesia to patients with chronic pain who were refractory to pharmacological treatment. Moreover, chronic pain was prevalent in all adult age groups and pain interventions were effective in all age groups alike. Key Words: Intervention, Pain, Patient satisfaction, Visual analogue scale.

Null.

Objective: To investigate the impact of open (Lichtenstein) and laparoscopic techniques (transabdominal preperitoneal procedure (TAPP), and total extraperitoneal procedure (TEP)) for inguinal hernia repair, on quality of life within a heterogeneous patient population, and to compare the findings with the Turkish normative values.

Study design: An experimental study. Place and Duration of the Study: Department of General Surgery, Samsun University Training and Research Hospital, Samsun, Turkiye, from January to July 2023.

Methodology: Open and laparoscopic inguinal hernia repair techniques were prospectively compared using data from 128 patients, the SF-36 quality of life questionnaire. A comparison of the SF-36 questionnaire data was made with the normative physical and mental function values representative of the Turkish population.

Results: A total of 64 patients underwent open surgery, while another 64 received laparoscopic surgery through randomisation. No statistically significant differences were observed between the two groups regarding age, gender, complications, chronic pain, or quality of life. Compared to the normative values of the Turkish population, the laparoscopic technique demonstrated significantly better outcomes in women for physical functions (p <0.001) whereas the open technique showed significantly better results in men regarding role limitation due to emotional problems (p = 0.049).

Conclusion: For inguinal hernia repair in the Turkish population, the open technique may be recommended for male patients, while the laparoscopic technique may be more suitable for female patients. However, surgical expertise and the patients' clinical condition should also be taken into account when determining the appropriate surgical approach.

Key words: Lichtenstein, Transabdominal preperitoneal procedure, Total extraperitoneal procedure, Inguinal hernia, Quality of life, Short form 36.