HIV Nursing

Preoperative and Operative Risk Factors for Conversion of Laparoscopic Cholecystectomy to Open Cholecystectomy

2023-09-23T04:37:33+00:00

Background: According to the world’s statistics, there are approximately 20 million people who are diagnosed with gallstones in the United States of America. Moreover, the occurrence of gallstones is 0.63/100 persons per year. According to research from Pakistan, the surgical occurrence of gallstones in females was 14.2 percent, and it was 4.2 percent in males. To treat gallstones, the gold standard treatment, which is used worldwide, is laparoscopic cholecystectomy (LC). It is important to have an understanding of and knowledge related to the preoperative and intraoperative factors that lead to conversion from LC to open cholecystectomy (OC). Objective: To study the risk factors (operative as well as pre-operative) that are associated with the conversion of laparoscopic cholecystectomy to open cholecystectomy. Study design: A cross-sectional study Place and Duration This study was conducted in Liaquat University Hospital Hyderabad from February 2022 to February 2023. Methodology: All of the participants of this study were diagnosed with symptomatic gallstones. Every patient was planned for laparoscopic cholecystectomy. There were a few operative factors, such as empyema, perforation, scleroatrophic (gross appearance of the gallbladder), and gallbladder adhesions. Furthermore, there were a number of pre-operative factors such as morbid obesity, age, previous endoscopic retrograde cholangiopancreatography (ERCP), liver function tests, previous upper abdominal surgery, alkaline phosphatase, total leukocyte count, alanine transaminase, severe sepsis, and total bilirubin. Results: There were a total of 1200 patients who were a part of this research. Among these 1200 patients, 92% successfully underwent laparoscopic cholecystectomy, while 8% had to undergo conversion to open cholecystectomy. The conversion rate in our study was 7.78 percent. The average age of the participants was 41.6 years. Morbid obesity was the most significant risk factor associated with the conversion. The most common reason for the conversion was finding difficulty in defining anatomy. Conclusion: Although laparoscopic cholecystectomy is the gold standard for treating gallstones, open cholecystectomy is a safer approach for people who are diagnosed with complicated gallbladders.

Results of Early Vs. Delayed Cholectectomy in Patients with Acute Gallstone Pancreatitis

2023-09-23T04:45:18+00:00

Background: According to research studies, gallstone-related diseases are the cause of about 75% of acute pancreatitis cases in well-developed countries. When there is constant biliopancreatic obstruction, there is progressive inflammation of the pancreas. This is how we can explain the pathogenesis of Acute Gallstone Pancreatitis (AGP). There might be repeating events of common bile duct obstruction, acute pancreatitis, self-limiting biliary colic, or acute cholangitis. AGP episodes are typically moderate and self-limiting. Nevertheless, 10% - 20% of patients develop acute pancreatitis, which has a significant mortality and morbidity rate. Objective: For patients having an early or delayed cholecystectomy following an episode of mild to moderate acute AGP, this study compares the time duration of the operation, perioperative complications, conversion rate, time duration of hospital stay, and rate of gallstone-related recurring problems. Study design: A Randomized Controlled Trial Place and Duration: This study was conducted in Federal General Hospital Islamabad Pakistan from March 2022 to March 2023. Methodology: The participants in this research were those who were diagnosed with mild to moderate acute gallstone pancreatitis. Patient with complication (pancreatic necrosis, pseudocyst pancreatic abscess) following pancreatitis were excluded All the individuals were aged between 18 and 75 years. The participants were randomly put into either a delayed cholecystectomy group (DC) or an Early Cholecystectomy group (EC). Laparoscopic cholecystectomy was performed in both groups. A pre-designed form was used to collect data regarding progress before surgery, during surgery, and after surgery. Results: There were a total of 100 people who met the inclusion criteria of our research from the Department of Surgery. All the individuals were aged from 18 years to 75 years. The average age calculated was 45.01 years. The participants were randomly placed in both groups and were equally divided (50 people in each group). The median time duration from diagnosis of acute gallstone pancreatitis to Laparoscopic Cholecystectomy (LC) was 7 days in the early cholecystectomy (EC) group, while it was 28 days in the delayed cholecystectomy (DC) group. There were a total of 8 people who were converted to open surgery, 5 in the EC group and 3 in the DC group. There were a total of 15 recurrent biliary events. Conclusion: DC was associated with a higher likelihood of recurring biliary episodes and hospital readmissions. This leads to increased patient morbidity and healthcare expenses.

The Role of C-Reactive Protein in Diagnosing Anastomosis Leakage in Patients with a Large Bowel Anastomosis

2023-09-23T04:48:10+00:00

Objective: In this study, our objective was to assess the diagnostic significance of C-reactive protein (CRP) as a predictive indicator for detecting anastomotic leakage in individuals who have undergone anastomosis of the large bowel. We employed computed tomography (CT) scans as the reference standard against which CRP's diagnostic utility was evaluated. Study design: A cross-sectional study Place and Duration: This study was conducted in Peoples University of medical and Health sciences for women Nawabshah, Pakistan from March 2022 to March 2023. Methodology: We enrolled 110 patients (ages 12-50 years, both genders) who underwent large bowel anastomosis, elective or emergency, achieving minimal cross-contamination. A concise medical history capturing symptoms and demographic details was collected. Bowel anastomoses were executed using the hand-sewn technique. Postoperative day 5 CRP levels >100 mg/L indicated an anastomotic leak. CT scans confirmed leaks through hyper density. Results: The subjects had a mean age of 42.89 ± 7.89 years. Surgery was more common in males (n=69, 62.72%) compared to females (n=41, 37.27%). CRP-based detection identified anastomotic leakage in 22 subjects (20%), while CT scans indicated leakage in 17 subjects (15.45%). Positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity, and overall diagnostic accuracy were 47.75%, 92.41%, 61.09%, 87.63%, and 83.52%, respectively. Conclusion: Considering CT scan as the gold standard, the diagnostic precision of CRP was noted in identifying leakage of anastomosis in patients undergoing large bowel anastomosis.

Serum Levels of Angiotensin II with Type 1 and Type 2 Diabetes Mellitus and Diabetic Nephropathy Patients

2023-10-09T08:43:01+00:00

Diabetic nephropathy (DN) is the leading cause of end-stage renal disease worldwide. Chronic hyperglycemia and high blood pressure are the main risk factors for the development of DN. 30%–40% of patients with diabetes develop DN, of which 5%–10% eventually progress to end-stage renal disease (ESRD). The present study was performed for the evaluation of Angiotensin II levels and their relationship with type 1 and type 2 diabetes mellitus and diabetic nephropathy in Al-Qadisiyah Province. To achieve this aim, 100 samples were collected, divided into 2 groups: those who are 40 Type 1 diabetes patients (20 T1DM with nephropathy and 20 T1DM without nephropathy); 40 Type II diabetes patients (20 T2DM with nephropathy and 20 T2DM without nephropathy); and healthy controls. Samples were collected from Al-Diwaniyah Teaching Hospital and Diabetes Center in Al-Qadisiyah Province from March 2022 to December 2022. Five milliliters of venous blood samples were obtained from each person under sterile conditions. Serum Ang-II (Angiotensin II) concentrations were estimated by an enzyme-linked immunosorbant assay. The data were analyzed using a variety of statistical methods. The results showed a significant (p < 0.05) decrease in serum Ang-II (Angiotensin II) in all patient groups, compared to diabetic subjects and healthy controls. Conclusions. Ang-II (Angiotensin II) is considered a very good diagnostic marker in type 1 diabetes and a good diagnostic marker in type 2 diabetes mellitus and diabetic nephropathy. This indicates that angiotensin II plays an important role in the development and progression of diabetic nephropathy.

Isolation and Diagnosis of Staphylococcus Aureus and Candida Albicans from Impetigo, Ecthyma, Bullous Impetigo Patients

2023-10-09T08:44:38+00:00

One of the skin infections that affect the skin is impetigo, Ecthyma, Bullous impetigo . Impetigo is a highly contagious superficial skin infection. It is a common skin infection in children and is most often caused by Staphylococcus aureus. Impetigo and ecthyma are common bacterial infections of the skin commonly caused by S. aureus and / or Group A streptoccus . Staphylococcus aureus has become the most common causative microbial pathogen of this prevalent childhood disease Impetigo can be bullous or non-bullous. A total of 120 specimens from clinically proven cases of bacterial skin infections, Impetigo (74 ) (61.7%) , Ecthyma ( 40) (33.3%), Bullous (6) (5.0%). in the Dermatological Consultation Unit in Marjan Hospital / Babylon Governorate. For the period from September 2022 to December 2022. Pathogens were diagnosed using direct examination, culture on differential media, and biochemical tests. Staphylococcus aureus (18%), Candida albican( 18%),Staphylococcus epidermidis (9%) , Staphylococcus saprophyticus(10 %) , Psedomonas. aeruginosa (7%). The aim of this study is Isolation and diagnosis of Staphylococcus aureus and candida albicans from impetigo , Ecthyma , Bullous impetigo patients .

Risk Factors and Biomarker Interleukin -12 of Breast Cancer Among Iraqi Women

2023-10-09T08:46:23+00:00

Background: Breast cancer and a few other malignancies are significantly more likely to develop in people This study aimed to identify the risk factors of Breast Cancer among Iraqi women. Participants in the study comprised 50 girls with breast cancer, and 50 girls in good health. In this study the distributing of patients into age groups revealed that most patients 17cases (34%) were at the age group (50-39) years old, 13 cases (26%) were at the age group (40-49)years old, 12 (24%) cases were at the age group (≥60) years old, 8 cases (16%) were at the age group (30-39) years oldIn conclusion, Positive risk factor for breast cancer was old age≥60 years, widow or divorced women, menopause, age at menarche <12 years, . Family history, seconddegree relative,not associated with breast cancer. There are some discrepancies between our findings and other studies in the literature need further studies.

Thyroid Hormones: The Body's Main Endocrine Organ

2023-10-09T08:47:59+00:00

The thyroid gland, the body's main endocrine organ, is situated in front of the thyroid cartilage in the anterior neck area. They are essential for almost all tissues to function at their best and have a big impact on a person's metabolism and oxygen consumption. The fact that thyroid-related endocrine disorders are among the most prevalent is not surprising. Around the world, hundreds of thousands of people struggle with thyroid issues. In order to clinically connect with illnesses that cause a hormone shortfall or excess, it is necessary to understand how it works. . thyroxin hormone consist of a tyrosine molecule joined to a phenyl ring by an ether bond. On their inner tyrosine rings, both have two iodine atoms. T4 and T3 are different from one another because T4 has two iodine atoms on its phenyl (outer) ring while T3 only has one. The amount of unbound or "Free" T4 and T3 (FT4 and FT3) is crucial for the biological effects of thyroid hormones, including feedback regulation to the anterior pituitary and hypothalamus. Plasma includes both bound and unbound (Free) thyroid hormones.

Polymorphism of IL-17A Related with Otitis Media

2023-10-09T08:49:22+00:00

Background: Otitis media (OM) is characterized as an infective and inflammatory state affecting the mucosa of the middle ear. Suppurative OM occurs when there is inflammation accompanied by discharge and perforation of the tympanic membrane. Methods: We genotyped 60 patients with otitis media, specimens taken from 30 patients, and 30 healthy people . Filling an EDTA tube with 2mL of blood, for the purpose of a molecular study for IL-17A. Blood specimens were saved under -20°C in frozen stat until uses. Results: A current study, highlight on the frequency of risk allele A in both heterozygous (GA) and Homozygous (AA) in SNP rs2275913 based on the Odd Ratio. The results shown lower in genotype GA was OR= 0.57(0.18 - 1.72) with p value 0.3, and the allele frequency was lower in with A allele. Conclusion: The Otitis media may be not correlated with polymorphism of IL17A but, this think was impossible based on the data of previous researches , which emphasized the pioneer of IL17A in Otitis media infection.

Comparing Planned Early Birth Vs Expectant Management of Premature Membrane Rupture at Term

2023-10-13T06:37:21+00:00

Background: In term pregnancies, immediate delivery has been linked to reduced maternal infection risk and increased maternal satisfaction compared to expectant management.Objective: This study aimed to evaluate maternal and neonatal outcomes in cases of term pre-labor rupture of membranes, comparing planned early delivery with expectant management. Study design: Analytical cross-sectional study Place and Duration: This study was conducted in Mayo Hospital Lahore from June 2022 to June 2023 Methodology: A total of 120 eligible pregnant women were purposefully assigned to two groups, ensuring age and gestational age matching between them. The first group consisted of 60 women who underwent labor induction using oxytocin, while the second group included 60 women whose labor commenced spontaneously, unless there were indications of fetal or maternal compromise, or until a 48-hour interval had transpired. In the latter case, labor induction was initiated using oxytocin as part of the expectant management strategy. Results: The mode of childbirth displayed a substantial correlation with parity in both study cohorts (p<0.001). However, the two sets had no discernible variations in maternal and neonatal consequences. Women in the expectant management group experienced significantly longer durations from admission to active labor, active labor initiation, and rupture of membranes to delivery (p<0.001, 0.03, and <0.001, respectively). onclusion: Both induction and expectant labor approaches yielded similar maternal and neonatal outcomes, although women in the expectant management group endured longer labor durations.

A Comparative Study: Vaginal Vs. Sublingual Administration of Misoprostol in the Management of Missed Miscarriages During the First Trimester

2023-10-13T06:43:08+00:00

Objective: This study aimed to evaluate the efficacy of sublingual administration of misoprostol compared to vaginal administration for the management of missed miscarriages in the first trimester. Study design: randomised controlled trial (RCT) Place and Duration: This study was conducted in Sandeman Provisional Hospital Quetta from April 2022 to April 2023 Methodology: The study included 140 patients. Following the International Federation of Obstetrics and Gynaecology (FIGO) protocol, patients were randomly assigned to two groups based on the route of misoprostol administration: sublingual (600 micrograms every 3 hours) or vaginal (800 micrograms every 3 hours). Each group had 70 patients. After 24 hours, patients were assessed for vaginal bleeding and expulsion; if neither occurred, the dose was repeated. In cases of persistent, significant vaginal bleeding after a maximum of two cycles, surgical evacuation was performed, as confirmed by pelvic ultrasound. Results: Both groups exhibited comparable characteristics in terms of mean age (25.23 ± 5.91 vs. 26.12 ± 5.94), parity (3.54 ± 0.49 vs. 3.53 ± 0.75), gestational age (8.82 ± 1.69 vs. 9.31 ± 1.61), and duration of induction to abortion interval (13.79 ± 3.48 vs. 12.89 ± 3.09), with no statistically significant differences (P-value > 0.05). The vaginal misoprostol group required a higher number of doses for complete miscarriage (4.23 ± 0.94 vs. 3.41 ± 1.14, P-value < 0.05). Sublingual administration provided a higher level of comfort (P-value < 0.05) with an 89.22% satisfaction rate compared to 54% in the vaginal misoprostol group. The sublingual misoprostol group exhibited a significantly higher success rate in 54 (77.14%) compared to the vaginal group in 40 (57.14%) (P-value < 0.05). Side effects such as vaginal bleeding (47 (67.14%) vs. 65 (92.85%)), bleeding exceeding menstruation (21 (30%) vs. 58 (82.85%)), and diarrhoea (22 (31.42%) vs. 42 (60.00)) were significantly associated with sublingual misoprostol use (P-value < 0.05). Conclusions: Sublingual misoprostol is a more effective option compared to vaginal administration for the management of first trimester missed miscarriages. Patients reported higher satisfaction and better outcomes with the sublingual route.

Studying the Incidence and Clinical Significance of Thrombocytopenia in Malaria Patients

2023-10-13T06:47:16+00:00

Background: Hematological abnormalities, including thrombocytopenia, anemia, and leukopenia, are frequently encountered in individuals with malaria. Objective: This study aimed at the assessment of the prevalence of thrombocytopenia in patients diagnosed with malaria in the study population. Study design: A cross-sectional study Place and Duration This study was conducted in Liaquat University of Medical and Health Sciences Jamshoro@Hyderabad from June 2022 to June 2023 Methodology: Patient data, encompassing demographics and medical histories, were collected using a pre-designed proforma. Hematological variables were derived from complete blood count (CBC) results and analyzed with a hematology analyzer. Additionally, clinical examinations were conducted for every participant who tested positive for malaria parasites as examined on a blood smear. The collected data underwent statistical analysis utilizing IBM SPSS version 26. Results: The study included a total of 120 patients, comprising 66 (55%) males and 54 (45%) females. Thrombocytopenia has been seen in 90% (n=108) of the 120 patients suffering from malaria. The breakdown of thrombocytopenia severity revealed grade 1 in 50% (n=60) of patients, grade 2 in 25% (n=30), grade 3 in 15% (n=18), and grade 4 in 10% (n=12) patients. Conclusion: This study affirms a high prevalence of thrombocytopenia among individuals with malaria. The findings underscore the significance of platelet counts as a crucial initial screening parameter for those presenting with acute febrile illnesses.

Prevalence of Thrombocytopenia in People with Malaria

2023-10-31T11:57:54+00:00

Background: One of the most common issues that causes high morbidity and mortality worldwide is malaria. Malaria is a vector-borne disease. Malaria’s transmission is done by female anopheles. The World Health Organization reported that 7.8 million people every year die because of malaria. Every year, more than 225 million people globally are affected due to malaria. Pakistan has a high prevalence of malaria, a major public health concern. Malaria is diagnosed by examining blood smears stained with Giemsa under a microscope. Malaria caused by the Plasmodium vivax parasite is more common and affects a broader population than Plasmodium falciparum malaria.Objective: To determine the prevalence of thrombocytopenia in malaria patients at a tertiary care hospital.Study design: A cross-sectional studyPlace and Duration This study was conducted in People's University of Medical and Health Sciences for Women Nawabshah from May 2022 to May 2023 Methodology: A total of 200 participants were selected for this research through the WHO sample size calculator. All the patients included in this research were diagnosed with malaria. The ages of all of the participants ranged from 18 to 60 years old. Every participant’s medical history and information related to demographics was collected through a pre-designed proforma. People who tested positive for malaria underwent clinical examinations.Results: There were a total of 200 peoples enrolled in this research. A total of 110 males and 90 females were included in this research. The average age calculated was 26 years. The majority of the patients were in the age range of 18 to 30 years. The frequency of thrombocytopenia against malaria was 180 (90%). Conclusion: In conclusion, thrombocytopenia is the most prevalent in those people who are diagnosed with malaria.

Management of Third Stage of Labour for Primigravidae with Singleton Pregnancies: Intravenous Oxytocin Alone vs Intravenous Oxytocin Combined with Sublingual Misoprostol

2023-10-31T12:00:30+00:00

The aim of this study is to compare and contrast the effectiveness of intravenous (IV) oxytocin alone and IV oxytocin combined with sublingually given misoprostol in managing the third stage of labor in primi gravid with singleton pregnancies who are giving birth vaginally.Study design: A randomized controlled trial Place and Duration: This study was conducted in Zulekha Hospital Sharjah U.A.E from June 2022 to June 2023 Methodology: A total of 140 patients were enrolled in the study. The participants were allocated into two study groups: group A and group B. Each study group consisted of 70 enrolled patients. Eligible participants were primigravidae at term, with singleton pregnancies with gestational ages ranging from 37 to 41 weeks and experiencing spontaneous labor. Patients with instrumental vaginal deliveries, antepartum bleeding, antepartum haemorrhage, or any underlying medical conditions, including pregnancy-induced hypertension, were not included in the study. Group A received 10 IU of IV oxytocin combined with sublingual misoprostol (400 mcg), while Group B received 10 IU of IV oxytocin alone. The main outcome measure was the comparison of mean blood loss between the two study groups.Results: In our study, most participants were aged between 26 and 30 years. The oxytocin + misoprostol group had an average age of 26.8 ± 2.8 years, while the oxytocin alone group averaged 27.1 ± 2.3 years. Excessive bleeding (>500 ml) was seen in 14.28% of the oxytocin-only group and 5.71% in the oxytocin-and-misoprostol group. Mean blood loss significantly differed: 362.5 ml for oxytocin + misoprostol and 407.2 ml for oxytocin alone (p-value <0.001). Shivering occurred in 7.14% of the oxytocin + misoprostol group and 1.42% of the oxytocin alone group.Conclusion: The combination of IV oxytocin and sublingual misoprostol proved more potent than IV oxytocin alone in controlling the loss of blood during the third stage of labor. The amount of blood lost was notably lower in the patients given combination therapy when compared to patients administered IV oxytocin exclusively.

Increased Uric Acid Levels in Patients with Hypertension: The Role of Calcium Channel Blockers and Beta Blockers

2023-10-31T12:03:00+00:00

Background: One of the most common issues that is arising globally is premature cardiovascular death, which is caused by hypertension. With the passage of time, the occurrence of cardiovascular diseases and hypertension is also increasing globally. Currently, the incidence of deaths that are caused by hypertension is about 33% worldwide.Objective: To do a comparison of the effects of calcium channel blockers and beta blockers on increased uric acid levels in people with hypertension.Study design: An analytical cross-sectional studyPlace and Duration: This study was conducted in Sulaiman Roshan Medical College Hospital TandoAdam from May 2022 to May 2023.Methodology: There were a total of 80 people selected to be a part of this research. All of the participants were diagnosed with hypertension. All of these participants were equally divided into 2 groups, 40 patients each. One group included those patients who received Metoprolol as an antihypertensive (Group A), and the other group received Amlodipine as an antihypertensive. The participants in this research were aged from 40 to 50 years. SPSS version 22 was used to analyze the data. A T-test was applied. MS Excel and Word were used to generate tables and graphs. Results: This research was conducted on a total of 80 patients who were equally divided into 2 groups. All of the participants were between 40 and 50 years old. The average age was calculated to be 46 years. The average weight was 73 kg. The average HbA1c level was 5.1%. There were a total of 42 males and 38 females.Conclusion: In conclusion, there was no significant difference between amlodipine and metoprolol on serum uric acid levels in patients with hypertension.

Family Planning Methods Utilization in Women of Reproductive Age

2023-11-07T15:31:12+00:00

Objectives: This study aimed to assess the level of knowledge and practices concerning Family planning (FP) utilization and its determinants among women within the reproductive age group in the population under study. Study design: Analytical cross-sectional study. Place and Duration: This study was conducted in Muhammad Medical College / Ibn-E-Sina University Mirpurkhas from May 2022 to 2023.: Data was gathered from 250 participants who visited the outpatient department of the hospital Methodology. A structured questionnaire was employed, and a nonprobability convenient sampling method was used for participant selection. Sociodemographic information, primarily pertaining to age, religion, educational status, occupation, and family income, was collected from participants. Data analysis was carried out using the Statistical Package of Social Sciences, version 26. Results: The study found that 182 (72.8%) women in the reproductive age group possessed knowledge about FP, while 137 (54.8%) practiced contraceptive methods. Among the participants, 142 (56.8%) acknowledged the effectiveness of contraceptive methods. The study revealed statistically significant associations between FP utilization practices and factors such as educational status, duration of marriage, knowledge, suitability, availability, number of children, husband support, and effectiveness of FP methods. The commonest sources of information on FP were FP centers and hospitals (40.8%), and the desire to conceive was the primary motivation (54%) for seeking FP services. Conclusion: The study concluded that there is a satisfactory level of knowledge about FP, but relatively low utilization of contraceptive methods among women in the reproductive age group. It is recommended that qualitative research approaches be utilized to gain deeper insights into women's perspectives and feelings regarding FP. Furthermore, further investigation into the reasons for the underutilization of FP services is warranted.

Clinical Indicators of Mortality and Diminished Functional Recovery in Hospitalized Patients with Acute Stroke

2023-11-12T15:51:59+00:00

Background: Acute stroke poses a significant global health challenge, with substantial morbidity and mortality implications. Recognizing the factors associated with unfavorable outcomes in patients experiencing acute stroke is essential for formulating tailored interventions to enhance patient prognosis. Objective: The primary objective of this study is the discovery of predictors of mortality and unfavorable functional outcomes in patients with acute stroke admitted to a hospital. Study design: A retrospective study Place and Duration: This study was conducted in Al-Tibri Medical College and Hospital Karachi from February 2022 to February 2023 Methodology: In this study, an analysis of medical records was executed, encompassing 200 patients who were admitted to the hospital due to acute stroke. The primary outcome measures consisted of mortality during hospitalization and inadequate functional status at the time of discharge and at the 3-month post-admission follow-up. Logistic regression analyses were carried out to discern the independent predictors associated with these outcomes. Results: Our analysis revealed that several factors were significantly associated with both unfavorable functional outcomes and mortality in patients suffering from acute stroke. These factors are age, NIHSS Score, comorbidities, hospital stay, and thrombolysis. Increasing age was associated with higher mortality rates and diminished functional status. A higher NIHSS score at admission was a predictor of worse outcomes. Patients with comorbid conditions such as hypertension, ischemic heart disease, diabetes mellitus, and various stroke subtypes were at increased risk for adverse outcomes. Prolonged hospitalization was related to a greater likelihood of unfavorable functional outcomes. Patients who did not receive intravenous thrombolysis exhibited a higher likelihood of experiencing unfavorable functional outcomes. Of the 200 patients diagnosed with acute stroke, a substantial portion, 28%, died during their hospital stay, while 61% demonstrated suboptimal functional outcomes at discharge, which increased to 73% at the 3-month follow-up. Conclusion: This investigation highlights multiple factors that serve as valuable predictors of adverse outcomes in patients having acute strokes admitted to the hospital. Early identification and management of modifiable risk factors, such as comorbidities and different types of stroke, could improve outcomes in this group of patients.

Treatment of Delayed Supracondylar Humerus Fracture in Paediatric Patients with Closed Callostasis: Our Hospital Experience

2023-11-22T08:04:06+00:00

Introduction: Supracondylar fractures of humerus (SCHFs) are frequently encountered in children. Delayed presentation of such fractures is particularly common. The absence of established guidelines for managing late-presenting SCHFs poses a clinical challenge. Objective: This study aimed to evaluate delayed SCHFs treated by the closure of Callostasis and percutaneous fixation. Study design: prospective cohort study. Place and Duration: This study was conducted in Ghulam Muhammad Mahar Medical College Sukkur from May 2022 to May 2023. Methodology: Children having Type III Gartland SCHFs with a delay of ≥7 days were included in the study. Children having Fractures with neurovascular injuries or requiring ORIF were excluded. Patients received treatment involving closed reduction followed by percutaneous cross-wire fixation under fluoroscopic guidance. A careful closed Callostasis was used to avoid excessive force. In cases where closed reduction was infeasible, the procedure was converted to open reduction. After verification of optimal alignment and pin placement with C-arm imaging, protruding K-wire ends were bent and left external. A long-arm cast or splint was applied with the elbow flexed and the forearm supinated. Outcomes were assessed using humerocaptellar angle, Flynn's criteria, and Baumann's angle. Results: The study included 50 patients with a mean age of 6.5±2.8 years (range: 2-12 years). The average presentation delay was 12.8±4.6 days, and the mean postoperative follow-up spanned 14.2±3.6 months. At the one-year follow-up, 46 (92%) patients demonstrated full range of motion (ROM), while 4 (8%) patients exhibited deficient ROM in both flexion and extension, primarily due to non-compliance with the prescribed treatment regimen. Flynn's criteria indicated excellent outcomes in 72% of cases. Conclusion: Closed osteoclasis, reduction, and percutaneous pinning offer a viable and effective method for addressing delayed displaced SCHFs.

Impact of High Vitamin C Intakes on the Development of Digestive Cancers

2023-11-23T05:18:54+00:00

Digestive cancer is a major public health problem with discreet and insidious evolution until the appearance of serious consequences in terms of morbidity and mortality. This work aims to demonstrate the impact of a diet rich in ascorbic acid on the evolution of digestive cancer. A descriptive observational study was carried out over a period of 3 months, for 30 patients with digestive cancer selected at the hospitals of Tlemcen, Nedroma and Ghazaouet, where a questionnaire was conducted. A diet was proposed, and a vitamin C dosage was carried out on the plasma of the patients before and after the introduction of this diet. Tumor locations were associated with fruits and vegetables consumption (p= 0.016). In addition, the vitamin C mean after the diet was significantly higher than before the diet (p< 0.0001), and there was a significant association between the improvement of patients' health and the vitamin C-rich diet (p< 0.0001), with a decrease in the effects of chemotherapy (39.13 %) or even a stabilization (34.78 %). Also, an improvement in the health status of the cancer patients (26.09 %) has been shown. In order to target preventive actions against digestive cancer, a better knowledge of the lifestyle of cancer patients, combined with a balanced diet supplemented with vitamin C, and a restriction of foods that acidify the blood pH is highly recommended.

Frequency of Hyperthyroidism in Atrial Fibrillation

2023-11-28T15:45:13+00:00

Introduction: Incidence of atrial fibrillation is increasing globally, and hyperthyroidism is a known precipitating factor for atrial fibrillation (AF). There are few studies that shown the frequency hyperthyroidism in patients presenting with AF, so we conducted this study. Methods and results: All patients presenting with atrial fibrillation in outpatient department of medicine and NICVD Nawabshah were included. We enrolled 96 patients with atrial fibrillation, out of these 61.5% were males and 38.5% females. Mean age of the subjects was (51.89 ±13.243) years. Mean age of females (45.81± 12.86). Most of subjects were in 41-60 years (52.1%) age group. The hyperthyroidism found in 16.7%. patients presenting with AF. We found statistically significant with presence or absence of thyroid antibodies. Conclusion: We found the hyperthyroidism common in patients presenting AF and need more multicenter studies to check the exact prevalence. All patients presenting with AF, the routine thyroid functions tests recommended.

Role of Troponin I in Prediction of Mortality in Covid 19 Patients

2023-11-28T15:53:22+00:00

While most COVID-19 cases present with mild respiratory symptoms resembling a common cold, the situation is globally serious. Severe outcomes are more prevalent in older male patients with underlying health conditions. Although, most COVID-19 cases present with mild respiratory symptoms resembling a common cold, yet severe outcomes are more prevalent in older male patients with underlying health conditions. As this is novel infection and its cardiac manifestations and outcomes are not fully determined yet in any population so there is a need to conduct a study to known prevalence of raised cardiac markers in Covid-19 infection in the absence of any cardiac defect so that further management can be planned. Our study showed that there is not only a raise in levels of Troponin-I but also has a strong association with increased mortality