Group Mean Age Research Articles

To Compare the Effectiveness of Low-Molecular-Weight Heparin and Unfractionated Heparin in Reducing Lower Limb Girth in Deep Vein Thrombosis.

Treating deep vein thrombosis (DVT) using a once-daily dose of enoxaparin offers greater convenience and the possibility of home-based care for certain patients, as opposed to a continuous infusion of unfractionated heparin (UFH). The study aimed to determine the most cost-effective thromboprophylaxis between low-molecular-weight heparin (LMWH) and UFHfor hospitalized patients. After obtaining clearance from the institutional ethical committee, the study was conducted in the Departmentof General Surgery, Sri Devaraj Urs Medical College, over a period of six months. Informed consent was obtained from all 46 patients included in this study. The participants were divided into two groups: group A received LMWHand group B received UFH. The mean age in group A was 59.8 + 10.6 years and in group B was 54.9 + 12.3 years. There was no significant difference in the girth of the lower limb between the groups during the follow-up period (p > 0.05). In group A, there was a highly significant reduction in lower limb girth from day one to day five (p < 0.0001), day five to day 10 (p < 0.0001), and day one to day 10 (p < 0.0001).In group B, there was no significant reduction from day one to day five (p = 0.06), but there was a significant reduction from day five to day 10 (p = 0.001) and day one to day 10 (p = 0.001). Treatment with LMWH as an anticoagulant significantly reduced the lower extremity girth and thrombus thickness in cases of DVT when compared to UFH.

Evaluating the Impact of Smoking and Hyperlipidemia in Patients with Atherosclerotic Cardiovascular Disease

Hyperlipidemia and Smoking are risk factors of atherosclerotic cardiovascular disease in Pakistani community. Objectives: To determine whether smoking and hyperlipidemia were associated with atherosclerotic cardiovascular disease. Methods: A comparative, cross-sectional study was conducted upon a sample of 200 male and female participants with different cardiac complications were selected and divided them into different groups like Group A and Group B. The individuals with medical complications such as severe chest pain, unexpected numbness or weakness in arms or legs and loss of vision were placed in Group A. While in Group-B 70 male and 30 female individuals with mild chest pain were include. BMI, Cholesterol, Triglyceride, LDL and HDL levels and other demographics such as age, smoking habits were measured respectively. Results: In Group A (severe disease group) there were 75 males and 25 females while in Group B (mild disease group) 70 male and 30 female individuals were listed. The mean age in Group A (59.09 ± 0.01) and Group B (59.09 ± 0.01). The results showed significant difference in Group A and B mean cholesterol (279.9 ± 0.04 vs. 239.09 ± 0.04), Triglycerides (187.02 ± 0.01 vs. 127.02 ± 0.01), LDL (153.01 ± 0.02 vs. 123.01 ± 0.02), HDL (49.04 ± 0.01 vs. 40.01 ± 0.01) and (p value&lt;0.05). Conclusions: It was concluded that hyperlipidemia and smoking were significant (p≤0.05) risk factors for atherosclerotic cardiovascular disease, as seen by increasing levels of cholesterol, Triglycerides and LDL in cardiovascular patients.

EXAMINING THE DECREASE IN SYMPTOMS IN PATIENTS WITH DACRYOCYSTORHINOSTOMY BOTH WITH AND WITHOUT SILICON INTUBATION A RANDOMIZED CONTROLLED TRIAL

Objective: To determine if dacryocystorhinostomy or silicon intubation is more effective in treating nasolacrimalduct obstructionStudy Design: A Randomized Controlled Trial StudyPlace and duration of study: This research was conducted over a six-month period, from October 9, 2021, to April 9,2022, at the Department of Clinical Ophthalmology, Khyber Girls’ Medical College, Hayatabad Medical Complex(HMC), Peshawar.Materials and Methods: The study comprised 446 patients with nasolacrimal duct blockage (NLDO). Eachpatient was split up into two cohorts. Group A had cryocystorhinostomy (DCR) with silicon intubation, whereasGroup B underwent DCR without intubation.Results: The average age of the sample was 35.1 + 9.2 years. The mean age of Group B was 35.2 + 9.1 years,whereas the mean age of Group A was 34.9 + 9.3 years (p 0.730). Group A consisted of 61.9% males and groupB had 56.5% males (p 0.248). The average number of days that symptoms persisted was 11 + 3.2 days in group Aand 10.4 + 2.9 days in group B (p 0.082). As determined by the overall remission of symptoms, group A’s efficacywas 79.4% at follow-up, whereas group B’s was 69.5% (p 0.017).Conclusion: For those with NLDO, silicon intubation significantly boosts the efficacy of DCR when compared toDCR without intubation.Key Words: Nasolacrimal duct obstruction, dacryocystorhinostomy, intubation, silicon, and efficacy.

Osteoporosis in Parkinson's disease and the role of lean body mass: a cross-sectional study in a Brazilian tertiary center.

Parkinson's disease (PD) is the second most common neurodegenerative illness and has the highest increase rate in recent years. There is growing evidence to suggest that PD is linked to higher osteoporosis rates and risk of fractures. This study aims to estimate the prevalence and factors associated with osteoporosis as defined by the National Osteoporosis Foundation (NOF) and World Health Organization in patients with mild to moderate PD. We performed a cross-sectional study at a tertiary public hospital in Fortaleza, Brazil, dating from May 2021 until April 2022. The study sample was comprised of patients with mild to moderate PD who were at least 40 years old and who had the ability to walk and stand unassisted. Bone Mineral Density (BMD) of both the hip (neck of the femur) and the lumbar spine were obtained via properly calibrated Dual Energy X-ray Absorptiometry (DXA) scanning. The FRAX (Fracture Risk Assessment Tool) score was used to determine a person's 10-year risk of major osteoporotic fracture. The Revised European Working Group on Sarcopenia in Older People (EWGSOP 2) was used as a basis to confirm a sarcopenia diagnosis with the following parameters: low muscle strength gauged by handgrip strength and low muscle quantity by DXA. Physical performance was carefully evaluated by using the Short Physical Performance Battery test. Osteoporosis and osteopenia were diagnosed following the NOF guidelines and WHO recommendations. We evaluated 107 patients in total, of whom 45 (42%) were women. The group's mean age was 68 ± 9 years, and the mean disease time span was 9.9 ± 6.0 years and mean motor UPDRS was 43 ± 15. We found that 42.1% and 34.6% of the sample had osteopenia and osteoporosis following NOF criteria, respectively, and 43% and 33.6% following the WHO recommendations. Lower lean appendicular mass was associated to osteopenia and osteoporosis in multinomial logistic regression analysis in both diagnostic criteria. Our findings provide additional evidence for the protective role of lean mass against osteoporosis in patients with PD.

A Prospective Study to Evaluate the Efficacy of Trenexamic Acid in Addition to Oxytocin for Prevention of Post Partum Hemorrhage

Background: One of the most prevalent causes of maternal mortality worldwide is postpartum hemorrhage which can be prevented by early prompt action. Active control of the third stage of labor is one such intervention that is strongly recommended.Methods: Prospective, randomized, comparative study conducted in Department of Obgyn in MY Hospital, Indore, with comparative groups of 500 each. One group received oxytocin alone and other group received oxytocin and trenexamic acid both.Results: The mean age in group I was 23.73 ± 3.53 years and in group II it was 23.83 ± 3.34 years, showing a comparable mean age between the two groups. The incidence of anemia was 9.6%, PPH was 6.0% and hemorrhagic shock was 0.6% in group I and in group II it was 8.0, 5.4 and 0.8%, respectively. The incidence of anemia and postpartum hemorrhage was higher in group I in comparison to group II. The mean blood loss in group I was 257.04 ± 139.17 mL, while in group II it was 242.60 ± 120.89 mL, showing a significantly lower blood loss in group II in comparison to the group I shows that trenexamic acid shows decrease and blood loss and anemia and occurance of PPH.Conclusions: Analysis concluded that tranexamic acid tended to minimize blood loss and the need for blood transfusions during childbirth during caesarean sections and vaginal deliveries and appeared safe and efficient for prevention and control of bleeding during pregnancy.

Psychiatric outcomes in outpatients affected by long COVID: A link between mental health and persistence of olfactory complaint.

Anosmia was one of the main symptoms of coronavirus disease 2019 (COVID-19). A psychiatric history (i.e., depression) may be an independent contributor to the risk of COVID-19 diagnosis, and COVID-19 survivors appear to have an increased risk of neuropsychiatric sequelae (bidirectional association). To compare the rate of psychiatric disorder among post-COVID patients without anosmia vs patients with persistent olfactory complaints. We conducted a prospective case control study from March 2020 to May 2021. Patients recruited at the ENT department of Nice University Hospital had a subjective olfactory complaint (visual analogue scale) for over 6 wk and a molecular or CT-proven severe acute respiratory syndrome coronavirus 2 diagnosis confirmed by serology. Post-COVID patients without persistent olfactory disorders were recruited at the university hospital infectiology department. Psychiatric medical histories were collected by a psychiatrist during the assessments. Thirty-four patients with post-COVID-19 olfactory complaints were included in the first group of the study. Fifty percent of the patients were female (n = 17). The group's mean age was 40.5 ± 12.9 years. The control group included 32 participants, of which 34.4% were female (n = 11), and had a mean age of 61.2 ± 12.2 years. The rate of psychiatric disorder among post-COVID patients with olfactory complaints was significatively higher (41.7%) than among patients without (18.8%) (χ2 = 5.9, P = 0.015). The presence of a psychiatric history may constitute a potential risk factor for the development of long COVID due to persistent anosmia. It therefore seems important to establish reinforced health monitoring after a COVID 19 infection in at-risk patients. Further prospective, translational, and collaborative studies are needed to extrapolate these results to the general population.

Evaluation of the Effects of Magnesium Sulphate versus Normal Saline on Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy

Introduction: Numerous studies have shown that giving magnesium sulphate intravenously before carbon dioxide pneumoperitoneum is produced reduces the adverse hemodynamic response in patients undergoing elective laparoscopic cholecystectomy. &#x0D; Objective: To examine the effects on hemodynamics in patients undergoing laparoscopic cholecystectomy between magnesium sulphate and normal saline.&#x0D; Methodology:The Department of Anaesthesia at the Pakistan Institute of Medical Sciences, SZABMU, Islamabad, conducted a Randomised Clinical Trial. The study involved the enrolment of 108 adult patients, regardless of gender, who were admitted for elective laparoscopic cholecystectomy and ranged in age from 18 to 65. Every patient who was enrolled was in ΑSΑ classes I and II. Patients were randomised equally to Group M, which received an IV slow bolus of magnesium sulphate (28 mg/kg) over a 20-minute period, and Group N, which received a 0.9% normal saline solution. The patient was tilted right and up by 15 degrees.&#x0D; Results:Both groups' baseline characteristics were comparable. The mean age of groups M and N was 42.2 years ± 7.6SD and 40.5 years ± 8.4SD, respectively (Ρ-value t-test=0.258). 22 (40.7%) men and 32 (59.3%) women made up group M, while 20 (37.0%) men and 34 (63.0%) women made up group N (Ρ-value chi-square = 0.693). Both groups' baseline and pre-pneumoperitoneum hemodyanamic parameters (HR, Systolic, BΡ, Diastolic BΡ, and MAΡ) were similar (Ρ-value t-test &gt; 0.05).&#x0D; Conclusions:The adverse hemodynamic response caused by pneumoperitoneum was significantly attenuated by pretreatment with intravenous magnesium sulphate. Heart rate, systolic blood pressure, diastolic blood pressure, and MTH were all significantly lower than baseline. Significant hypotension and bradycardia, however, were not seen.

Prevalence and treatment rates of osteoporosis among individuals with rotator cuff tears

BackgroundThe relationship between osteoporosis and rotator cuff tears has been reported previously. However, the treatment rate of osteoporosis in individuals with rotator cuff tear is still unknown. The aim of this study was to investigate the prevalence and treatment rate of osteoporosis in individuals with rotator cuff tears. MethodsIn this cross-sectional study, we enrolled 207 participants. Participants underwent comprehensive assessments, including shoulder ultrasonographic examinations and quantitative ultrasound (QUS) measurements for bone status evaluation. Osteoporosis diagnosis was predicated on a calcaneus ultrasound bone densitometry, and the cutoff value was set as a T score of -1.455, with reference to a previous report. Results156 participants were classified as individuals without rotator cuff tears (group A), and 51 participants were classified as those with (group B). The mean age in group A was significantly lower than that in group B (63 ± 10 vs. 68 ± 9, respectively; p = 0.003). In terms of the T score examined by QUS, the mean T score in group A was significantly higher than that in group B (-1.4 ± 1.3 vs. -1.9 ± 1.6, respectively; p = 0.0412). The percentage of subjects with a T score of -1.455 or less in group B was 60.8% (31/51). The proportion of subjects with a T score of -1.455 or less undergoing osteoporosis treatment was 14.5% (12/83) in group A and 12.9% (4/27) in group B, showing no significant difference. ConclusionsParticipants with a rotator cuff tear had relatively high prevalence of osteoporosis. Among those with both a rotator cuff tear and osteoporosis, the proportion receiving osteoporosis treatment was l2.9%, a very low rate.

Effect of Buerger-Allen exercise on wound healing in patients with diabetic foot ulcers: a randomised controlled trial.

A diabetic foot ulcer (DFU) is a complication of type 2 diabetes that is difficult to treat. Buerger-Allen exercise has shown effectiveness in improving foot circulation and neuropathy in several studies; however, to the best of our knowledge, no randomised controlled study has investigated its effectiveness for DFU healing. Therefore, this study aimed to assess the effects of Buerger-Allen exercise on the healing of DFUs in patients with type 2 diabetes. This is a parallel-group randomised controlled trial (RCT). Of 50 patients with neuropathic DFUs, 41 completed the study. They were assigned randomly to a study group (n=21) and a control group (n=20). Patients in the study group received the standard medical treatment and semi-supervised Buerger-Allen exercise for three sessions per week for four weeks, while patients in the control group only received the standard medical treatment. The outcome measures were: ankle-brachial pressure index (ABPI); ulcer size; ulcer depth; SINBAD score; and ulcer risk for poor outcomes (based on the SINBAD score). The study group's mean age was 49.48±6.45 years and the control group's mean age was 49.15±5.85. The study group's ABPI increased significantly compared to the baseline (1.17±0.04 versus 1.11±0.05, respectively; p<0.001) and the control group (1.17±0.04 versus 1.14±0.05, respectively; p=0.04) post-intervention. Ulcer size also reduced significantly in the study group compared to the baseline (2.63±2.0 versus 7.48±5.55cm2, respectively; p<0.001) and the control group (2.63±2.0 versus 6.43±4.45cm2, respectively; p<0.001) post-intervention. Ulcer depth decreased significantly in the study group compared to the baseline (1.71±1.05 versus 4.19±1.74mm, respectively; p<0.001) and the control group (1.71±1.05 versus 2.80±1.57mm, respectively; p=0.01) post-intervention. Furthermore, the SINBAD score in the study group decreased significantly compared to the baseline (1.38±0.86 versus 2.14±1.06, respectively; p<0.001) and the control group (1.38±0.86 versus 2.0±0.79, respectively; p=0.02) post-intervention. Moreover, the ulcer risk for poor outcomes, based on the SINBAD score, reduced significantly only in the study group, compared to the baseline (p=0.041). The control group showed non-significant changes compared to the baseline in all outcome measures (p>0.05). From the findings of this RCT, Buerger-Allen exercise, in combination with standard wound care, may help accelerate the healing of neuropathic DFUs in patients with type 2 diabetes, and could be suggested as part of the management plan for such conditions as an easy-to-perform offloading exercise intervention.

Comparison of the effect of 2 mL versus 3 mL sub-Tenon xylocaine injection on akinesia and analgesia in cataract patients at the University of Ilorin Teaching Hospital, Nigeria.

Sub-Tenon anesthesia is a form of local anesthetic techniques used in ophthalmic procedures, especially in cataract surgery. Few studies in our environment have reported the effects of sub-Tenon anesthesia on akinesia and analgesia as well as optimum volumes of anesthetic agents that are required for effective analgesia and akinesia. The objective of this study is to determine and compare the level of analgesia and akinesia and the effect of ocular compressions after sub-Tenon injection of 2 mL versus 3 mL of xylocaine among patients booked for cataract surgery in the University of Ilorin Teaching Hospital (UITH). A cross-sectional comparative study among cataract patients booked for surgery in the Department of Ophthalmology at UITH was carried out from March 2017 to August 2017. A total of 200 cataract patients that met the inclusion criteria were recruited into the study over 6 months. Lists of cataract patients booked for surgery formed the sampling frame. Questionnaires were administered to obtain information on sociodemographic, ocular symptoms, and other histories. Visual acuity was checked, and ocular examination was done with a pen-torch, ophthalmoscope, and slit-lamp examination with 78D. Tonometry and optic nerve assessments were done to exclude any patient with preexisting glaucoma or suspicious disc. About 200 patients were randomly allocated into one of two volume groups (Group 1 had 2 mL sub-Tenon xylocaine injection whereas Group 2 had 3 mL); level of analgesia and akinesia was checked 12 min and 15 min, respectively. The age range was 20-107 years; mean age for Group 1 was 63.8 ± 12.64, whereas the mean age of Group 2 was 64.14 ± 14.14. There was a slight female preponderance given a M:f of 1:1.4 and more than half of the patients presented with right eye (RE) cataract. Levels of analgesia 12 min after sub-Tenon injections in both groups were similar. However, two patients were found to have severe pain in Group 1, and no patients had severe pain in Group 2. The level of akinesia which was assessed 15 min after injection in both groups was found to be significantly better in Group 2. There was a slight female preponderance with about two-third of the total patients being female and the percentage of females who had no pain was more than the male, more than 50% of the patients had RE cataracts. Sub-Tenon anesthesia whether with 2 mL or 3 mL led to a statistically significant rise in intraorbital pressure (IOP); however, with ocular compression, the IOP was found to decrease below the preinjection pressure in both groups. Levels of analgesia were similar in the two groups, whereas akinesia was statistically better in the group that had 3 mL injection.

Variable arachnoid cyst presentations in variable age groups; a comparative single center study

Introduction. Arachnoid cysts are an intracranial spaces that are filled with cerebrospinal fluid (CSF) and lined with arachnoid membranes. They may be asymptomatic or present with focal epilepsy, headache and other neurological symptoms. Purpose. This study shows the different presentation of brain arachnoid cysts in relation to their locations in variable age groups. Methods. This is a retrospective analytic cohort comparative study that enrolled 168 patients was done in the Middle Euphrates Neuroscience Center and Al-Sadder Medical City, from the first of February 2020 to the first of February 2023. The collected data of patients include patient’s age, gender, presentation, location of the cyst in the brain and its dimension. Each patient was assessed a full general and neurological examination. The data were analyzed according to presentation and location of cyst in the brain via MRI. Results. The mean age of group one is 10 years (4-18 years) and for group two is 35 years (19-70 years). Regarding the gender, the male gender was more in group one, while the female gender was more in group two than in group one. Regarding the presentation, the most common presentation is focal epilepsy in about 47.61% in both groups and more in group one (about 68.11%). Regarding the MRI location of arachnoid cyst, the most common site was the temporal lobe. The overall percentage of arachnoid cyst is 57.14% in temporal lobe and 13.09% in occipital lobe in total patients Conclusion. The arachnoid cysts of brain are variable in both their presentations and their locations in different ages. The most common presentation is focal epilepsy in patient 18 years old and less, while the headache in patient older than 18 years. The most common site of cyst is temporal lobe.

Choosing Retrograde Intrarenal Surgery Versus Mini-Percutaneous Nephrolithotomy in Proximal Ureteric Stones

Background Proximal ureteric stone is one of the common presentations in renal stones disease. Safety, efficacy and stone free rate of retrograde intrarenal surgery and mini percutaneous nephrolithotomy are controversial. Thus, we aim to compare the efficacy, safety and stone free rates of two procedures.MethodsThis was a retrospective observational study including 60 cases divided into group A (Retrograde-intrarenal Surgery) and Group B (Mini-Percutaneous Surgery) between September 2022 to August 2023. Ethical approval was obtained from Institutional review Committee (Reference number: CMC-IRC/079/080-100). Convenience sampling was done.ResultsThe mean age in group A was 43.83 ± 16.92 years and in group B was 46.33 ± 15.78 years with no significant p value (p = 0.112). Post operative haemoglobin changes in group A was 0.266 ± 0.279 gram% and in group B was 1.493 ±0.360 gram% with significant P value of 0.001. Similarly the duration of operation in Group A was 42.43± 13.783 minutes and in group B was 36.30 ± 7.173 minutes with significant P value 0.035. However the stone free rate was higher in group B than Group A without significant P value of 0.064. Both of the groups have minor post operative complication of fever and mild haeamaturia.Conclusions The stones clearance rate of mini percutaneous nephrolithotomy is better than retrograde intrarenal surgery and the safety of retrograde intrarenal surgery is higher than of mini percutaneous surgery.

A Comparison of Mini Open Transverse Incision and Longitudinal Incision for the Release of Moderate and Severe Carpal Tunnel Syndrome.

Carpal tunnel syndrome is a common condition seen in daily clinical practice. Multiple minimally invasive techniques have emerged in the last decades for median nerve decompression. However, many research are needed to study the outcome on the patients and their safety profile. We will compare group A that includes patients operated on using the minimally invasive transverse incision (number of patients = n = 221, females 76.7% and males 22.8%) versus group B that includes patients operated on using the longitudinal incision (n = 194, female 70.1% and male 29.9%) in term of clinical satisfactionand safety. The mean age of group A is 58.1±5.1 and that of group B is 58.8±4.8. The male and female distribution in both groups and the mean age were both similar with no statistically significant difference for the age (p = 0.79) or the gender distribution (p = 0.1). Data collected prospectively at regular intervals in time (preoperatively and at one month, three months, and six months post-carpal tunnel release (CTR)) between January 2006 and December 2021 were reviewed retrospectively. Patients' clinical findings, grip strength measurement using a hand dynamometer, and postoperative satisfaction measured using the BCTQ (Boston Carpal Tunnel Syndrome Questionnaire) scoring system were recorded and analyzed for each technique. A total of 415 patients were included in our study. All patients included had moderate to severe median nerve compression documented by nerve-conducted studies with positive Tinel's and Phalen's signs. Baseline demographics between group A (CTR through a longitudinal palmar mini-incision) and group B (CTR with a mini-transverse incision at the palmar crease) didn't show a statistically significant difference.Both groups showed improved grip strength and BCTQ scores at the post-operative follow-up. Median nerve decompression using both types of incisions has resulted in the same functional outcomes and patient satisfaction.

Comparison of Efficacy of Topical Betamethasone Dipropionate and Topical Minoxidil in Patients With Alopecia Areata.

Background and objective Alopecia areata (AA) is a reiterative and nonscarring type of hair loss that can affect any hairy area of the body, particularly the scalp. It manifests as patchy or confluent hair loss with variations in demographics and ethnicity. There are numerous treatment options available, including topical and systemic steroids, topical minoxidil, dithranol, tacrolimus, psoralen and ultraviolet therapy (PUVA), contact immunotherapy, and oral immunosuppressive drugs. However, no previous contrast for efficacy is present between the topical betamethasone versus topical minoxidil alone in our population. This study aims to compare the efficacy of topical betamethasone dipropionate versus topical minoxidil in patients with AA. Methodology A nonrandomized controlled study was conducted at the Department of Dermatology, Jinnah Hospital Lahore, incorporating the data of patients between July 26, 2016, and January 26, 2017, after obtaining institutional ethical approval. One hundred patients with alopecia, either on the scalp or any other hairy part, from both genders, aged between 18 and 50 years, were included in the study. Two groups were created, and patients were assigned to these groups based on the clinician's choice. Group A patients were administered betamethasone dipropionate (0.05%) lotion twice daily on affected areas for 12 weeks. Group B patients were administered minoxidil (5%) solution twice daily on affected areas for 12 weeks. A four-week follow-up plan was followed. A five-point scale score system was used for alopecia grading. After 12 weeks, the hair regrowth score (RGS) was used to compare the efficacy of treatment between the two groups. Results A total of 100 patients with grades S1 to S3 AA of less than three months duration were enrolled. Two groups were created, with 50 patients in each group. The mean age in Group A was 29.08 ± 6.51 years, while in Group B, it was 29.38 ± 6.62 years. In Group A, there were 76% males and 24% females, while in Group B, there were 74% males and 26% females. Comparison of efficacy of topical betamethasone dipropionate versus topical minoxidil in patients with AA demonstrated a greater efficacy of 74% (Grade 3 and Grade 4 responses) in Group A, while in Group B, only 42% of patients showed efficacy. A statistically significant difference was found, with a P-value of 0.001. No serious side effects were noted. Conclusions Our study concluded that topical betamethasone dipropionate (0.05%) lotion has statistically significantly higher efficacy compared to topical minoxidil (5%) solution in patients with AA.

The Impact of a Short Hospital Stay on Readmission Rate after Laparoscopic Colorectal Cancer Surgery under the Enhanced Recovery after Surgery Protocol

Objective: The aim of this study is to examine the safety of discharge after a one or two day hospital stay following laparoscopic colorectal cancer surgery under the enhanced recovery after surgery protocol. Methods: This retrospective study was conducted at the colorectal unit in the King Hussein Military Hospital. All patients who underwent laparoscopic resection of colorectal cancer between January 2020 and December 2023 were included and grouped according to their hospital stay: Group A had a short stay of one to two days, and Group B a stay of more than two days. Demographic information, type of surgery performed, postoperative complications, and readmission data were collected from the colorectal unit and hakeem data base. Results: Two hundred and eighty patients were included in this study: 104 patients in Group A and 176 patients in Group B. The mean age in Group A was 57.7 ± 12.82 years and in Group B 58.42 ± 13.04 years. In Group A, 46.1% were female, compared to 39.2% in Group B. The mean body mass index was similar in both groups. In Group A, 34.6% of patients were smokers, compared to 29% in Group B. The readmission rate was 9.6% in Group A and 11.4% in Group B. Conclusion: Early discharge of patient within two days following laparoscopic colorectal cancer resection is safe and was not associated with increased rates of readmission.

Functional Outcomes and Gait Analysis of Total Hip Arthroplasty Through Lateral Hardinge Approach and Gluteus Medius-Sparing Approach: A Prospective Study.

Background and objective Hip degenerative joint disease is a common and debilitating musculoskeletal disorder. Total hip arthroplasty (THA) is a reconstructive hip procedure to relieve this condition through various surgical approaches. This study aimed to compare the functional outcomes between patients undergoing THA using the lateral Hardinge approach and the lateral gluteus medius-sparing approach. Material and methods This prospective study was carried out at a tertiary care institution.Thirty patients with arthritic hip joints were managed with total hip replacement (THR). The patients were allocated into two treatment groups; in group A, 14 patients received a THRby the lateral Hardinge approach, whereas in group B, 16 patients were managed by the lateral gluteus medius-sparing approach. Functional outcomes were assessed by the Harris Hip Score (HHS), and gait analysis was performed. Results The mean age of group A was 39.79 ±14.01 years and that of group B was 37.00 ±14.81 years. The mean length of incision was significantly lower in group B(p=0.001), whereas the mean duration of surgery (p=0.018) and mean contralateral pelvic tilt were found to be significantly lower in group A (p=0.009). No significant difference was found in abductor muscle strength, limb length discrepancy, HHS, pelvic obliquity, and pelvic rotation. Conclusion While functional outcomes were similar in both groups, the group that underwent THA with thegluteus medius-sparing approach had better gait based on lower pelvic tilt.

COMPARISON OF PLATELET RICH THERAPY ALONE WITH PLATELET RICH THERAPY ALONG WITH DAILY TOPICAL 5% PROCAPIL APPLICATION FOR THE TREATMENT OF ANDROGENETIC ALOPECIA.

Androgenetic alopecia (AGA) affects up to 50% of males and 40% of females by the age of 50. It is the result of progressive, patterned hair loss that occurs in genetically predisposed individuals having hypersensitive androgen receptors in hair follicles. Due to the variable efficacy and adverse effect profile of FDA-approved drugs, newer and alternative modalities need to be utilized. As no prior study evaluated the efficacy of Procapil in combination with platelet-rich plasma (PRP), this study aimed to fill the research gap. The objectives were to assess the effectiveness of topical Procapil 5% combined with PRP vs PRP alone in androgenetic alopecia. It was a Quasi-experimental clinical trial conducted at the Tehsil Headquarters Hospital Takhtbhai Mardan. One hundred and sixty patients with AGA were selected and divided into two groups, 80 in each. Group A received 4 sessions of PRP alone, 4 weeks apart while Group B was treated with PRP in combination with topical 5%procapil solution applied twice a day. Final results are calculated at the end of 6 months using 7- 7-point patient' satisfaction and dermatologist evaluation scoring systems. The mean age in Groups A and B was 29.34±5.3 & 30.22±4.8 respectively. Disease duration was comparable between both groups. At the final Assessment Greater proportion of patients in group B achieved better scores on Dermatologist evaluation and Patient satisfaction scales (p-value<0.05). It has been established that combining PRP with 5% Procapil yields better results in treating AGA compared to PRP used alone.

A Randomized Controlled Trial Comparing Injection Polidocanol, with Injection 50% D/W in Rectal Prolapse

Background: Rectal prolapse manifests as the protrusion of the rectal mucosa through the anal opening. There can be partial or full thickness prolapse. It usually occurs before 4 years of age. Rectal prolapse in childhood tends to affect both males and females equally. Aim: To compare Inj. Polidocanol with Inj 50% D/W in rectal prolapsed in this randomized controlled trial. Methods: The study was conducted in the pediatric surgical ward of Mayo Hospital &amp; King Edward Medical University Lahore, after receiving approval from the Hospital's Ethical Committee. There were 60 patients rectal prolapse with 30 patients in each group. Polidocanol was used in group A while 50%dextrose water was used in group B. The procedure was performed under general anesthesia. In the postoperative period children were observed for early complications like fever, anaphylaxis, diarrhea, hemorrhage, pain while defecating, mucosal edema and constipation. Results were analyzed with SPSS. Results: Out of 60, 36 were male while 24 were female. Group A included 16 male and 14 females whereas group B had 20 males and 10 female children. Mean age was 5.35years with SD of 2.7 and ranging from youngest child of 8 months till eldest of 12 years. In group A mean age was 5.44 while mean age of group B was 5.26 years. All 30 patients in group A were relieved of their symptoms after single session of Polidocanol so giving 100% of success rate while 28 patients (93.33%) in group B were relieved of their symptoms while 2(6.66%) patients developed recurrence with no significant difference. The complications observed in the study were post-operative constipation in 3(10%) patients in group A, however no patient developed postoperative stricture, infection or adverse drug reaction. In group B no patient developed any post-operative complication. Practical Implication: This comparative study helps us to find more effective and better drug available as a sclerosing agent to treat rectal prolapse in pediatric population. It’s also cost effective and with fewer side effects and easily available. Conclusion: In conclusion, injection sclerotherapy using polidocanol emerges as an equally successful procedure for managing RP in children. This medication demonstrates enhanced efficacy, safety, and accessibility. The process is not only less time-consuming but also entails minimal complications. Keywords: Rectal Prolapse Manifests, Protrusion, Mucosa, Chronic Constipation, Hirschsprung’s Disease,

Effects of 6 weeks of step aerobics training on pulmonary functions among female students with sedentary lifestyle

Background: Sedentary lifestyle is among the leading cause of cardiovascular and respiratory diseases over the globe. Aerobic conditioning is among the beneficial intervention to improve pulmonary function and manage the complications caused by sedentary life style. Objective: To determine the effects of step aerobics training on pulmonary function among female students with Sedentary Lifestyle. Methods: This RCT was conducted in Margalla Institute of Health Sciences from February to July 2019. Nonprobability convenient sampling was employed to collect sample of 80 students, randomly allocated into groups (40 per group) by coin toss method. Group A performed step aerobics and Group B performed cycling for 6 weeks. Pulmonary function test (FVC, FEV1, PEF) and 3-minute step test was performed at baseline, after 2, 4 and 6 weeks in both groups. Heart rate and oxygen saturation was monitored pre and post exercise. Results: The mean age of Group A is 22.43±2.49 and Group B is 21.80±2.04. Results showed statistically significant difference in respiratory function between groups. Significant improvement of respiratory function was observed in group A which performed aerobics program as compared to group B. The level of significance was set on p &lt;0.05. Conclusion: Step aerobics is considered beneficial in improvement of pulmonary functions and is a good alternative for conditioning program for female adults. Cycling also improved pulmonary function but the progress was slow as compared to step aerobics which showed quick impact in improving pulmonary function test. Clinical Trial Number: NCT04051788

Postoperative Tobacco Cessation Improves Quality of Life, Lung Function and Long-Term Survival in Non-Small-Cell Lung Cancer Patients.

About 90% of all non-small cell lung cancer (NSCLC) cases are associated with inhalative tabacco smoking. Half of patients continue smoking during lung cancer therapy. We examined the effects of postoperative smoking cessation on lung function, quality of life (QOL) and long-term survival. In total, 641 patients, who underwent lobectomy between 2012 and 2019, were identified from our single institutional data base. Postoperatively, patients that actively smoked at the time of operation were offered a structured 'smoking cessation' program. For this retrospective analysis, two patient groups (total n = 90) were selected by pair matching. Group A (n = 60) had no postoperative tobacco smoking. Group B (n = 30) involved postoperative continued smoking. Lung function (FEV1, DLCO) and QOL ('SF-36' questionnaire) were measured 12 months postoperatively. We compared long-term outcomes using Kaplan-Meier curves. The mean age in group A was 62.6 ± 12.5 years and that in group B was 64.3 ± 9.7 years (p = 0.82); 64% and 62%, respectively, were male (p = 0.46). Preoperative smoking habits were similar ('pack years': group A, 47 ± 31; group B, 49 ± 27; p = 0.87). All relevant baseline characteristics we collected were similar (p > 0.05). One year after lobectomy, FEV1 was reduced by 15% in both groups (p = 0.98). Smoking cessation was significantly associated with improved DLCO (group A: 11 ± 16%; group B: -5 ± 14%; p <0.001) and QOL (vitality (VT): +10 vs. -10, p = 0.017; physical role function (RP): +8 vs. -17, p = 0.012; general health perceptions (GH): +12 vs. -5, p = 0.024). Patients who stopped smoking postoperatively had a significantly superior overall survival (median survival: 89.8 ± 6.8 [95% CI: 76.6-103.1] months vs. 73.9 ± 3.6 [95% CI: 66.9-80.9] months, p = 0.034; 3-year OS rate: 96.2% vs. 81.0%, p = 0.02; 5-year OS rate: 80.0% vs. 64.0%, p = 0.016). The hazard ratio (HR) was 2.31 [95% CI: 1.04-5.13] for postoperative smoking versus tobacco cessation. Postoperative smoking cessation is associated with improved quality of life and lung function testing. Notably, a significant increase in long-term survival rates among non-smoking NSCLC patients was observed. These findings could serve as motivation for patients to successfully complete a non-smoking program.