搜索结果：Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

To conduct the bibliometric analysis of the Journal of the College of Physicians and Surgeons Pakistan (JCPSP) from 2012 to 2014. The prime objectives of this report were to determine the number and percentage of articles by year, authorship pattern, gender and geographical affiliation, ranking by subject and citation analysis. A data collection instrument was developed as bibliometric form. The data was analysed using the Microsoft Excel spread sheet. Editorials and letters to editors were excluded. There were 1106 total research documents, including 721 original articles and 385 case reports. A rapid increase in number of articles per year was noticed, more original papers than case reports. Majority of the authors were male. The contribution of Balochistan and Khyber Pakhtunkhwa was less than the other provinces. JCPSP was the most cited document in the reference list of the research documents. The scholars of Khyber Pakhtunkhwa and Balochistan and female researchers should give more attention in writing quality articles eligible for consideration at this Journal. It is also suggested that writers should be compelled to address such fields of medical sciences as neurology, nephrology, anatomy and pharmacology, while writing original articles and case reports.

To evaluate the effectiveness of the American College of Radiology (ACR) Neck Imaging Reporting and Data System (NI-RADS) in the response evaluation of head and neck neoplasms following therapy, utilising contrast-enhanced CT or MRI. A descriptive study. Place and Duration of the Study: Department of Radiology, Shifa International Hospital, Islamabad, Pakistan, from December 2023 until July 2024. Post-treatment CT or MRI scans from 70 patients with head and neck cancer were reviewed. Each scan was assessed according to the NI-RADS lexicon and categorised accordingly. Diagnostic accuracy was determined by comparing NI-RADS findings with histopathological results and/or clinical follow-up at a three-month interval, and positron emission tomography (PET), where available. Cases were classified as true negatives (NI-RADS 1 and 2) or true positives (NI-RADS 3 and 4) when imaging findings were concordant with the reference standards, whereas discordant findings were classified as false negatives (NI-RADS 1 and 2) or false positives (NI-RADS 3 and 4). Sensitivity, specificity, and accuracy were calculated using SPSS. Recurrence was confirmed in 25 patients either histopathologically or through clinical evaluation and PET, where available. The overall accuracy of NI-RADS categorisation was 82.86% after taking into account all concordant cases (i.e., true positives reported as NI-RADS 3, NI-RADS 4, and true negatives reported as NI-RADS 1 and NI-RADS 2) and discordant cases (i.e., false positives reported as NI-RADS 3, NI-RADS 4, and false negatives reported as NI-RADS 1 and NI-RADS 2) of the primary tumour site. The negative predictive value (NPV) was 92% for NI-RADS 1 and 76.92% for NI-RADS 2, while the positive predictive value (PPV) was 69.23% for NI-RADS 3 and 100% for NI-RADS 4. For neck lesions, the NI-RADS algorithm demonstrated a sensitivity of 80%, specificity of 100%, and an overall accuracy of 98.59%. The ACR NI-RADS system demonstrates high diagnostic accuracy and reliable risk stratification for post-treatment surveillance of head and neck cancer patients. Its structured reporting format facilitates a consistent evaluation and aids in guiding clinical decision-making. Head, Neck, Neoplasms, Recurrence, Risk, NI-RADS lesion.

To assess the use of subdermal sterile water injections (SWIs) as a cost-effective and reliable analgesia option for labouring women in setups with high patient flow, limited staff availability, and favourable delivery outcomes. Randomised clinical trial. Place and Duration of the Study: Department of Maternal and Child Health, Pakistan Institute of Medical Sciences Hospital, Islamabad, Pakistan, from August 2024 to January 2025. A total of 212 labouring women in the active stage of labour were randomly assigned using the lottery method to either the Trial group, which received subdermal SWIs, or the Control group, which received the standard labour ward protocol. Pain levels were assessed using the Numerical Pain Scale (NPS), with a pain-score of <7 considered indicative of effective pain control. The primary outcome was the pain control before and after the intervention, while the secondary outcome was the mode of delivery. The Mann-Whitney U test and the chi-square test were used to compare variables between groups. The Wilcoxon signed-rank test was used to compare pain scores before and after the intervention within the trial group. The study indicated that 94% of women in the Trial group reported effective pain relief (NPS 4-6) at 10, 30, and 60 minutes after the use of SWIs compared to the Control group, which was considered clinically significant. Additionally, 92% of women in each group had a normal vaginal delivery (p >0.05), making no difference in delivery outcomes in both groups. This study shows that the use of subdermal SWIs is an effective method for labour pain relief and represents a cost-effective analgesic option for labour pain management in low-resource settings. Sterile water, Subdermal, Labour pain, Analgesia, Epidural, Vaginal delivery.

OBJECTIVE: The recent emphasis on using "evidence based medicine" for decision-making in patient care issues has prompted many publishers to mention the level of evidence of articles in their journals. The "quality" of a journal may thus be reflected by the proportion of articles with high levels of evidence, apart from other criteria. We aimed to determine the level of evidence of articles in indexed Pakistani medical journals. METHODS: Two journals were selected: Journal of Pakistan Medical Association (JPMA) and Journal of College of Physician and Surgeons, Pakistan (JCPSP). Based on the information in the abstracts, all articles from 2003 and 2006 were categorized according to guidelines of Center for Evidence Based Medicine, Oxford, UK. RESULTS: 882 items/articles were reviewed. Of these, 270 (31%) were scientific articles within which 51% belonged to the "Therapeutic" and 25% to the "Prognostic" type. Only 27% had a high level of evidence (1 and 2) while a majority of 55% had level 4 evidence. Although there was a higher proportion of scientific research articles in JCPSP than JPMA (36% vs. 25%). no major difference in the levels of evidence was noted between the two journals, nor between 2003 and 2006. Moreover, the results were quite comparable to similar international studies. CONCLUSION: The level of evidence in articles in our leading local journals compares favourably with international literature. We recommend that levels of evidence be stated with abstracts in local journals not only to help the clinicians in making decisions on the best available evidence, but also to elevate the "quality" of these journals.

To assess the effectiveness of deep learning-based diagnostic software in identifying oral leukoplakia (OL) lesions from intraoral patient photographs. An observational study. Place and Duration of the Study: Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkiye, from February to November 2024. A dataset comprising 222 anonymised retrospective intraoral images, confirmed as OL via incisional biopsy, was labelled using the polygonal annotation tool in CranioCatch software. Expert reviewers validated all annotations. The dataset was split into training (n = 178), validation (n = 22), and test (n = 22) subsets. The models used for lesion detection included YOLOv5, YOLOv8, Mask R-CNN, and U-Net. The model's effectiveness was measured using the confusion matrix. Precision, recall, and F1- score performance provided quantitative assessments of the model's predictive capabilities. YOLOv5 demonstrated the highest performance with an F1-score of 0.845, sensitivity of 0.967, and precision of 0.750. YOLOv8 followed closely with an F1-score of 0.760, sensitivity of 0.871, and precision of 0.675. In contrast, Mask R-CNN and U-Net showed comparatively lower effectiveness, achieving F1, sensitivity, and precision values of 0.408, 0.588, and 0.312 for Mask R-CNN, and 0.629, 0.518, and 0.800 for U-Net, respectively. YOLOv5 and YOLOv8 models outperformed Mask R-CNN and U-Net in accurately detecting OL lesions. These findings highlight the promise of artificial intelligence in facilitating early diagnosis of potentially malignant oral conditions. As datasets expand and algorithms improve, the clinical utility of such AI systems is expected to grow, contributing to timely intervention and improved patient outcomes. Oral mucosal lesions, Oral leukoplakia, Deep learning, Artificial intelligence.

To determine the diagnostic accuracy of anti-Desmoglein 1 (Dsg1) and anti-Desmoglein 3 (Dsg3) antibodies detected by the enzyme-linked immunosorbent assay (ELISA) in clinically suspected cases of pemphigus vulgaris (PV). A cross-sectional study. Place and Duration of the Study: Department of Immunology, the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from July to December 2024. A total of 105 clinically suspected PV patients were enrolled using a non-probability consecutive sampling technique. Serum was analysed for the detection of Dsg1 and Dsg3 antibodies by the ELISA, with histopathology and direct immunofluorescence used as the reference methods for skin biopsy examination. The diagnostic accuracy of the ELISA was assessed through sensitivity, specificity, positive and negative predictive values, and Cohen's kappa statistics. A total of 105 clinically suspected cases, comprising 50 (47.6%) males and 55 (52.4%) females (male-to-female ratio 10:11), were included. PV was detected in 82 (78%) cases by both Immunofluorescence and histopathology, while 23 (22%) were diagnosed as other (non-PV). Among the PV, 70 (85.4%) were positive for both Dsg1 and Dsg3 antibodies, while 12 (14.6%) were negative. Anti-Dsg1 and 3 positivity was observed in 10 (9.5%) and 5 (4.7%) non-PV cases, respectively, diagnosed as pemphigus foliaceus and bullous pemphigoid. Both anti-Dsg1 and anti-Dsg3 yielded equal sensitivity of 85.4%; however, the specificity of anti-Dsg1 was lower (56.5%) than that of anti-Dsg3 (78.3%) antibodies. Both anti-Dsg1 and anti-Dsg3 antibodies detected by the ELISA demonstrated good sensitivity; the comparatively lower specificity of anti-Dsg1 antibodies, however, restricted its applicability in PV in resource-limited settings. Pemphigus vulgaris, Desmoglein1, Desmoglein3, Enzyme-linked immunosorbent assay, Sensitivity, Specificity, Immuno-fluorescence.

To evaluate the expression of Human Epidermal Growth Factor Receptor (HER) family members (HER1, HER2, HER3, and HER4), along with Ki-67 and E-cadherin in oral squamous cell carcinoma (OSCC), and to determine their prognostic and therapeutic relevance in relation to clinicopathological parameters. A cross-sectional observational study. Place and Duration of the Study: Department of Oral and Maxillofacial Surgery, Diagnostic and Research Laboratory, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, from September 2023 to September 2025. Formalin-fixed, paraffin-embedded OSCC tissue samples (n = 138) were stained with haematoxylin and eosin and classified according to the WHO/Broder's grading system and the AJCC TNM staging system. Immunohistochemistry was performed to evaluate the expression of HER1-HER4, Ki-67, and E-cadherin. Statistical analysis was performed using SPSS version 26, utilising descriptive statistics and chi-square tests, with p <0.05 considered statistically significant. The study included 138 OSCC cases, comprising 73.2% males and 26.8% females, with a mean age of 44.7 &#xb1; 11.8 years. Buccal mucosa was the most prevalent site (60.99%). HER1 and HER3 were expressed in 79.0% of cases, while HER2 expression was minimal (2.9%). HER3 and HER4 demonstrated significant association with the TNM stage (p <0.05 and p = 0.044, respectively). Ki-67 was highly expressed (88.4%) and significantly correlated with the TNM stage (p = 0.045). E-cadherin showed a significant association with histological grade (p = 0.001). HER1 and Ki-67 emerged as strong predictors of tumour aggressiveness, while HER3 and HER4 were linked with advanced disease characteristics. Therapy against these markers could be promising in OSCC. Oral squamous cell carcinoma, Biomarkers, Prognosis, EGFR family, Therapy.

To investigate the results of swab cultures obtained from lesions of patients with hidradenitis suppurativa (HS) and their antibiotic resistance. An observational study. Place and Duration of the Study: Department of Dermatology and Venereology, Ankara Etlik City Hospital, Ankara, Turkiye, from October 2022 to May 2024. A total of 123 patients aged &#x2265;18 years diagnosed with HS, from whom swab cultures were taken from purulent lesions, were included in this study. Data on the Hurley clinical staging system of HS, disease duration, previous antibiotic use, the areas of lesions from which cultures were obtained, and the results of culture and antibiotic resistance were recorded. Descriptive statistical methods were used to evaluate the data. The mean age was 39.1 &#xb1; 13.7 years in 35 (28.5%) female and 88 (71.5%) male patients. The mean duration of HS was 156 &#xb1; 140 months. Patients were mainly classified as Hurley 2 (n = 73, 59.3%), Hurley 3 (n = 33, 26.8%), and Hurley 1 (n = 17, 13.8%). A total of 113 patients (91.9%) had a history of antibiotic use. The highest growth in culture was observed in lesions obtained from the axillary region (n = 75, 61%). Skin flora were observed in swab cultures in 94 patients (76.4%), and non-skin flora grew in 29 patients (23.6%). Among the 29 patients, the most common was Staphylococcus aureus (n = 11, 37.9%). The highest rates of resistance were observed to ampicillin (n = 11, 8.9%), clindamycin (n = 7, 5.7%), and penicillin G (n = 7, 5.7%). Antibiotic resistance was detected in the antibiograms of 23 patients with non-skin flora. The highest resistance rates were observed to ampicillin (n = 11, 47.8%), clindamycin (n = 7, 30.4%), and penicillin G (n = 7, 30.4%). Given the predominance of skin flora in HS lesions, biological agents may offer more effective long-term management than antibiotics for patients with HS. Antibiotic treatment, Antibiotic resistance, Hidradenitis suppurativa, Biologic treatment.

To evaluate the effectiveness of silicone oil retention sutures versus inferior peripheral iridectomy (PI) in avoiding silicone oil migration in vitrectomised unicameral aphakic eyes. A quasi-experimental study. Place and Duration of the Study: College of Ophthalmology and Allied Vision Sciences, King Edward Medical University/Mayo Hospital, Lahore, Pakistan, from March 2023 to August 2023. Patients aged over 20 years, of either gender, who underwent pars plana vitrectomy resulting in single-segment vitrectomised aphakic eyes, were randomly segregated into two study groups. In Group A, patients underwent pars plana vitrectomy with the placement of 10-0 Prolene sutures applied through the anterior chamber of the eye (retention sutures), followed by silicone oil endotamponade. In Group B, patients underwent pars plana vitrectomy with inferior PI, followed by silicone oil endotamponade. All the patients were followed up for four weeks, after which a comparative analysis was performed using SPSS version 28. The chi-square test was applied to compare the two surgical techniques. A total of 102 patients were enrolled in this study. Patients enrolled in Group A had a mean age of 49.55 &#xb1; 7.44 years. Those enrolled in Group B had a mean age of 45.96 &#xb1; 8.36 years. In Group A, there were 39 (76.5%) males and 12 (23.5%) females. In Group B, there were 33 (64.7%) males and 18 (35.3%) females. In Group A, prolapse of polydimethylsiloxane (PDMS)/silicone oil into the ocular anterior chamber was observed in six (11.8%) eyes. In Group B, migration of PDMS/silicone oil into the anterior chamber was observed in 16 (31.4%) eyes. A statistically significant difference in PDMS/silicone oil prolapse into the anterior chamber of the eyes was observed between the two study groups (p <0.05), proving that the retention suture group was superior to the PI group. The silicone oil retention suturing technique is associated with a lower frequency of PDMS/ silicone oil migration into the anterior chamber compared to the current gold standard, inferior PI, after pars plana vitrectomy in unicameral aphakic eyes. Silicone oil retention sutures, Inferior peripheral iridectomy, Anterior chamber, Vitrectomised, Unicameral, Aphakic eyes, Endotamponade, Polydimethylsiloxane.

To examine the factors influencing immune-related adverse events (irAEs) in lung cancer (LC) patients undergoing treatment with immune checkpoint inhibitors (ICIs) and to develop and validate a prediction model. An observational study. Place and Duration of the Study: Department of Oncology, the Second People's Hospital of Datong, Shanxi, China, from January 2020 to July 2024. The demographic characteristics and blood biomarkers of 108 LC patients treated with ICIs were evaluated retrospectively within one week before and after at least one course of therapy treatment. To compare categorical variables, &#x3c7;2 or Fisher's exact test was used. Univariate and multifactorial logistic regression analyses were conducted using the forward stepwise method to determine independent predictors of irAEs. Brain metastasis (BrMs), ECOG-PS, TNM stage, IL-1 (after), IL-4 (after), IL-6 (after), IL-8 (after), IL-10 (after), WBC (after), and NLR (after) were statistically significant in the univariate logistic analysis and were then included in the multifactorial analysis. Univariate and multivariate logistic regression models were employed to estimate the odds ratios (OR) and their 95% confidence intervals (CI). The analysis revealed that BrMs (OR = 0.053, 95% CI: 0.009 to 0.305, p = 0.001), interleukin-10 (IL-10, OR = 1.866, 95% CI: 1.347 to 2.584, p <0.001), and white blood cells (WBC, OR = 1.310, 95% CI: 1.060 to 1.620, p = 0.013) were identified as independent factors influencing the occurrence of&#xa0;irAEs (p <0.05). The joint prediction model achieved a C-index of 0.937 (95% CI: 0.889-0.981). The ROC curve for the subjects achieved an AUC of 0.966 (95% CI: 0.935-0.997). The calibration curve closely approximated the ideal curve, suggesting that the model exhibited strong discrimination and calibration. The decision curve analysis demonstrated that the predictive model provided a substantial net clinical benefit. The model developed using post-dose IL-10, WBC levels, and BrMs indicators demonstrates significant diagnostic value for irAEs. Immune checkpoint inhibitors, Lung cancer, Immune-related adverse events, White blood cells, Interleukin-10, Brain metastases.

Assessment of research articles in terms of study designs used, statistical tests applied and the use of statistical analysis programmes help determine research activity profile and trends in the country. In this descriptive study, all original articles published by Journal of Pakistan Medical Association (JPMA) and Journal of the College of Physicians and Surgeons Pakistan (JCPSP), in the year 2015 were reviewed in terms of study designs used, application of statistical tests, and the use of statistical analysis programmes. JPMA and JCPSP published 192 and 128 original articles, respectively, in the year 2015. Results of this study indicate that cross-sectional study design, bivariate inferential statistical analysis entailing comparison between two variables/groups, and use of statistical software programme SPSS to be the most common study design, inferential statistical analysis, and statistical analysis software programmes, respectively. These results echo previously published assessment of these two journals for the year 2014.

To assess the effect of bilateral erector spinae plane block (ESPB) on postoperative analgesic requirements, patient and surgeon satisfaction, postoperative stress response, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values in patients undergoing lumbar discectomy. A randomised-controlled trial. Place and Duration of the Study: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Harran University, Sanl&#x131;urfa, Turkiye, from January to December 2023. Sixty patients, aged between 18 and 65 years and classified as American Society of Anaesthesiologists (ASA) I-II, who were candidates for single-level lumbar discectomy, were randomly allocated into two groups. Thirty patients received ESPB (Group E), while 30 did not (Group C). Intraoperative vital signs, postoperative analgesic needs, Numerical Rating Scale (NRS) scores, patient and surgeon satisfaction, surgical stress factors, NLR and PLR values, side effects, and complications were recorded. The Kolmogorov-Smirnov Test was used to evaluate the normality of the sample distribution. Independent samples and paired-samples t-tests were used to compare the two groups. The Pearson's chi-square test was used for categorical variables. The Mann-Whitney U test was employed to compare satisfaction scores. In Group E, the NLR was significantly lower at the sixth postoperative hour compared to Group C (p = 0.003). Postoperative opioid use and NRS scores were markedly lower in Group E than in Group C, with the time to first bolus administration being significantly longer in Group E. The ESPB in single-level lumbar discectomies was associated with a lower NLR, an established indicator of inflammation. Additionally, ESPB provided lower postoperative opioid requirements and pain scores. Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Erector spinae plane block, Lumbar discectomy, Postoperative analgesia.

To compare the levels of burnout among family physicians working in rural and urban areas and to examine factors associated with burnout, including workplace violence, smoking, alcohol consumption, and professional experience. A cross-sectional study. Place and Duration of the Study: Department of Family Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkiye, from January to July 2025. A total of 513 family physicians (265 rural, 248 urban) participated in the study. Data were collected via online questionnaires assessing demographics, lifestyle behaviours, workplace characteristics, and exposure to verbal or physical violence. Burnout levels were measured using the Burnout Measure Short version (BMS). The median burnout score was 4.00 (IQR = 2.9). The overall prevalence of burnout (BMS &#x2265;3.5) was 46.9%, slightly higher in rural physicians (48.3%) compared to urban physicians (45.4%), with no statistically significant difference between groups (U = 32636.5, p = 0.894). Physicians exposed to workplace violence had significantly higher burnout scores (median 4.6 vs. 3.7; 95% CI: 0.52-1.14; p <0.001, indicating a moderate effect size. Similarly, those who smoked (median 4.5 vs. 3.8, p = 0.012) and consumed alcohol (median 4.4 vs. 3.9, p = 0.028) had higher burnout levels. Greater professional experience and older age were associated with slightly lower levels of burnout. Burnout levels among family physicians did not significantly differ by geographic location. Workplace violence, smoking, and alcohol consumption were significantly associated with higher burnout levels. Enhancing workplace safety and promoting healthy coping mechanisms may help reduce burnout and improve physician well-being and healthcare quality. Burnout, Family physicians, Workplace violence, Smoking, Alcohol use, Rural health, Urban health.

ABSTRACT&#xa0; Objective: To evaluate the predictive efficacy of standardised remnant liver volume (SRLV) combined with the albumin-bilirubin- fibrosis-4 (ALBI-FIB4) score for posthepatectomy liver failure (PHLF) in patients with hepatocellular carcinoma (HCC). A descriptive and analytical study. Place and Duration of the Study: Department of Radiology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China, from February 2022 to February 2024. Clinical and imaging data of 80 patients with HCC who underwent partial hepatectomy were retrospectively analysed. Subjects were divided into two cohorts: those with non-PHLF (n = 62) and those who developed PHLF (n = 18). Receiver operating characteristic (ROC) curve analysis was employed to compare the predictive performance of SRLV, ALBI score, FIB-4 index, ALBI- FIB4 score, SRLV+ALBI score, SRLV+FIB-4 index, and SRLV+ALBI-FIB4 score for the occurrence of PHLF. Among the 80 patients, 18 (22.5%) developed PHLF. The SRLV+ALBI-FIB4 scoring model demonstrated superior diagnostic efficacy, with an area under the ROC curve (AUC) of 0.825, outperforming individual and other combined models, including SRLV (AUC = 0.719), ALBI score (AUC = 0.698), FIB-4 index (AUC = 0.679), ALBI-FIB4 score (AUC = 0.773), SRLV+ALBI score (AUC = 0.801), and SRLV+FIB-4 index (AUC = 0.775). The SRLV+ALBI-FIB4 scoring model integrates anatomical and functional liver reserve parameters, offering enhanced predictive accuracy for PHLF compared to traditional single- or combined-index models. This approach provides a valuable tool for preoperative risk assessment and surgical decision optimisation in HCC patients. Hepatocellular carcinoma, Liver failure, Postoperative complications, Liver function tests, MR volumetry, Posthepatectomy, ALB1-FIB4 score.

To determine the frequency of electrolyte imbalances in children aged 2-60 months admitted with acute gastroenteritis (AGE), and to evaluate their associations with the length of hospital stay (LOS) at a secondary care hospital. An observational study. Place and Duration of the Study: Department of Paediatrics and Child Health, Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan, from January to December 2023. The data were collected from the patient's hospital medical record on a structured pro forma. Descriptive statistics such as mean and standard deviation were reported for continuous variables, while frequency and percentage were reported for categorical variables. Associations between electrolyte imbalances and length of hospital stay were assessed using the chi-square and Fisher's exact test. Univariate logistic regression analysis was also done to identify individual predictors associated with prolonged hospitalisation. A total of 361 children admitted with AGE were included. The mean age was 16.6 &#xb1; 12.3 months. Nearly all patients, 98% (352), had decreased bicarbonate levels (acidosis). Other common electrolyte imbalances included hyponatraemia in 34% (123) and hyperchloraemia in 33% (121). Excluding bicarbonate, 5% (18) had problems in all three electrolytes (sodium, potassium, and chloride). There was a significant association between multiple electrolyte imbalances and length of hospital stay (p = 0.006). Univariate analysis also showed significant associations between LOS and hyponatraemia (OR = 1.90 [95% CI:1.07-3.36]), hypochloraemia (OR = 3.18 [95% CI: 1.38-7.33]), and antibiotic use (OR = 2.18 [95% CI: 1.17-4.07]). Electrolyte disturbances in AGE were significantly associated with length of hospital stay, emphasising the need for early recognition and correction of electrolyte disturbances to optimise patient outcomes and reduce hospitalisation duration. Gastroenteritis, Electrolytes, Length of hospital stay.

To integrate multiscale embedded gene co-expression network analysis (MEGENA) and Mendelian randomisation (MR) to identify new pathogenic factors associated with breast cancer (BC). A descriptive study. Place and Duration of the Study: Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China, from January to December 2024. The raw mRNA expression data were downloaded from the Cancer Genome Atlas (TCGA) database, and differentially expressed genes were used for MEGENA analysis. MR analysis was applied to explore causal relationships. A sensitivity analysis using leave-one-out tests ensured robust results. Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) were used to examine the functions and mechanisms of the newly identified targets. MEGENA analysis identified 257 targets. The MR analysis demonstrated that ALOX15B (0.874; 0.809-0.943; p = 0.001) and TLE3 (0.807; 0.667-0.976; p = 0.027) were associated with a low risk of the disease; while the genes FAAH (1.064; 1.003-1.129; p = 0.038), HDGF (1.158; 1.012- 1.326; p = 0.032), KLF5 (1.110; 1.020-1.208; p = 0.015), LSM4 (1.071; 1.001-1.145; p = 0.046), and TNS1 (1.073; 1.015-1.135; p = 0.013) were associated with a high risk of BC. Six (ALOX15B, FAAH, HDGF, KLF5, TLE3, and TNS1) of these seven genes have been further validated for their reliability through sensitivity analysis. These six genes are closely correlated with immune cell infiltration and multiple tumour-related pathways. This study demonstrated the causal effect of six key genes on BC and provided a potential molecular link between these genes and BC. Breast cancer, Mendelian randomisation, MEGENA, Biomarker, Immune infiltration.

To assess the effect of preoperative oral carbohydrate intake on the quality of recovery in elderly patients undergoing total knee arthroplasty (TKA), using the Quality of Recovery-15 (QoR-15) questionnaire. A randomised, placebo-controlled study. Place and Duration of the Study: Department of Anaesthesiology and Intensive Care Medicine, Karaman Training and Research Hospital, Karaman, Turkiye, from June 2024 to January 2025. One hundred patients aged &#x2265;65 years scheduled for TKA were randomly assigned to either a placebo group (PG, n = 50) or an oral carbohydrate group (OCG, n = 50). Participants in the PG received 300 mL of water for 3 hours before surgery, while those in the OCG received 300 mL of a liquid carbohydrate drink 3 hours preoperatively. The primary outcome measure was the QoR-15 score assessed 24 hours postoperatively. Total QoR-15 scores were normally distributed and compared between groups using an independent samples t-test. Other secondary outcomes, including patient well-being, delirium frequency (assessed using the Confusion Assessment Method and the Mini-Mental State Examination), and sleep quality, were also evaluated. The QoR-15 scores were significantly higher in the group OCG (121.94 &#xb1; 9.4) than in the PG (115.76 &#xb1; 12.26) on the first day postoperatively (6.1; 95% CI: 1.8 to 10.5, p = 0.006). The parameters indicating patient well-being (thirst, dry mouth, fatigue, nausea, and vomiting) were lower in the PG than in the OCG after surgery. Oral carbohydrate intake before surgery could improve the quality of postoperative recovery, well-being, and satisfaction of elderly patients undergoing TKA 24 hours after surgery. Knee arthroplasty, Oral carbohydrate intake, Delirium, Fasting, Quality of recovery.

To test the diagnosis of early carpal tunnel syndrome (CTS) by assessing dorsal extension, distal sensation, and motor latency. An observational study. Place and Duration of the Study: Department of Orthopaedic Surgery, Longgang District People's Hospital of Shenzhen and the Second Affiliated Hospital of the Chinese University of Hong Kong, Shenzhen, China, from March 2018 to July 2023. Electromyography was performed on 82 hands of 62 patients with CTS. Distal sensory and motor latency measurements before and after the compression were analysed. Paired t-test was used to analyse the experimental data. Compared to before compression (DSL = 4.17 ms, DML = 5.25 ms), the results showed that the distal sensory and motor latency of the median nerve were significantly longer in mild cases (DSL = 4.73 ms, DML = 5.51 ms). However, the sensory nerve action potential (SNAP) and compound muscle action potential (CMAP) were significantly lower, decreasing from 13.56 &#x3bc;v and 6.69 mv to 13.09 &#x3bc;v and 6.27 mv, respectively. In moderately severe patients, the DSL was significantly longer than before compression, with the mean value increasing from 4.38 ms to 4.86 ms. Electromyography in the dorsal extension position of the wrist has practical value in the diagnosis of early CTS. Wrist carpal tunnel syndrome, Median nerve, Electromyography, Dorsal extension.

To identify trends in neonatal mortality and morbidity among neonates admitted to neonatal intensive care unit&#xa0;(NICU). A descriptive study. Department of Paediatric Medicine, Services Institute of Medical Sciences and Services Hospital, Lahore, Pakistan, from January 2022 to July 2023. Data were collected using a pre-designed and standardised pro forma to ensure consistency and accuracy. The study cohort was followed from the time of admission until discharge, leaving against medical advice (LAMA), or death. SPSS software (version 27.0) was utilised for statistical analysis to determine the frequency and percentage of different morbidity and mortality parameters. A p-value of 0.05 was considered significant. In 19 months, a total of 1,324 newborns (males, 56.95%) were admitted, and 31.26% (n = 414) died. Prematurity (29.53%, n = 391) was the most frequent reason for admission, followed by septicaemia (20.61%, n = 273), neonatal jaundice (9.89%, n = 131), birth asphyxia (8.9%, n = 118), and meconium aspiration syndrome (MAS; 5.9%, n = 79). Case mortality rate was more in prematurity (51.91%, n = 203/391), followed by birth asphyxia (45.76%, n = 54/118), congenital anomalies (37.03%, n = 10/27), septicaemia (27.10%, n = 74/273), pneumonia (25%, n = 11/44), respiratory distress syndrome (RDS; 24.63%, n = 17/69), MAS (22.78%, n = 18/79), meningitis (15.30%, n = 15/98), and transient tachypnoea of neonates (TTN; 5.26%, n = 4/76). Prematurity, low birth weight, and septicaemia were the leading causes of neonatal mortality, showing a strong inverse correlation with survival. Timely care and management of term neonates and conditions such as jaundice significantly improved outcomes. Admission, Neonates, Morbidity, Mortality, NICU, Fatality.