Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jun 2021
Psychological Burden amongst Caregivers of Patients on Maintenance Haemodialysis.
Long-term caregiving is a difficult job, risking mental health of involved individuals. This study was planned to document magnitude of the problem at Pak Emirates Military Hospital, Rawalpindi, with an aim to improve quality of life in caregivers and patients alike. From January to June 2019, caregivers accompanying haemodialysis patients were selected using consecutive sampling technique. ⋯ Males had lower scores than females (28.01 ± 11.18 vs. 35.22 ± 14.65, respectively; p= 0.026). Gender of caregivers significantly predicted ZBI scores; while their age, job status, education, monthly income and duration of caregiving did not. Key Words: Caregivers, Chronic kidney disease, Haemodialysis, Long-term care, Psychological burden.
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Atypical polypoid adenomyoma (APAM) is a rare polypoidal benign tumor of uterus, which usually presents with irregular vaginal bleeding in women of reproductive age. It has the potential of malignant transformation but does not metastasise. It may coexist with endometrial hyperplasia and adenocarcinoma; and so, is usually misdiagnosed. ⋯ A 25-year woman with irregular vaginal bleeding and abdominal mass had total abdominal hysterectomy (TAH) on suspicion of endometrial sarcoma. Histopathology specimen revealed APAM. On follow-up so far, she is in stable condition and asymptomatic. Key Words: Atypical polypoid adenomyosis, Adenosarcoma, Endometrial carcinoma.
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J Coll Physicians Surg Pak · Jun 2021
Observational StudyResuscitative Thoracotomy as a Life-saving Intervention in the Emergency Department.
To investigate the survival rate and the return of spontaneous circulation (ROSC) in patients who underwent the resuscitative thoracotomy in the emergency department (EDRT), and determine the difference in survival rate of the patients who underwent EDRT with and without out of hospital CPR. ⋯ Performing EDRT increases the survival in penetrating injuries, especially in stab-wounds. Patients gain time for an advanced intervention. Furthermore, EDRT provides life guardians time to assess for organ donation when death is inevitable. Key Words: Blunt trauma, Cardiac arrest, CPR, Emergency thoracotomy, Gunshot injury; Organ donation, Resuscitation, Resuscitative thoracotomy, Stab-wound injury; Trauma resuscitation.
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J Coll Physicians Surg Pak · Jun 2021
Audit of Documentation of Forensic History on Admission Form in a Psychiatric Intensive Care Unit.
To study the documentation of relevant components of forensic history on admission form for male patients admitted in psychiatric intensive care unit (PICU)/OAK ward of Phoenix Care Center. ⋯ Drugs and alcohol and previous charges were documented in most of the cases, but documentation of protection/baring order and encounter with the police without being charged was a neglected area, which should be worked upon in future. Key Words: Admission form, Forensic history, Medical audit.
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To demonstrate the predictive effect of PSA derivatives and time markers that is prostate-specific antigen (PSA) doubling time (PSADT) and PSA velocity (PSAV) on survival in men with hormone-refractory prostate cancer (HRPCa). ⋯ The patients were grouped according to the mean PSADT, median PSAV, median nadir PSA, and mean time to HRPCA. The survival of those with high PSADT, low PSAV and low nadir PSA were found to be significantly longer (p=0.006, p<0.001, p<0.001). High PSAV was also associated with significantly increased PSA, nadir PSA and death (p<0.001, p=0.47, and p<0.001, p=0.52, respectively). The survival of those with a longer time to HPRCa was found to be significantly longer (p<0.001). There was no statistically significant difference in terms of survival between patients who received chemotherapy after HRPCa and those who did not (p=0.477). PSAV (p=0.007 HR: 1.004 95% CI: 1.001 - 1.007), bone metastasis at diagnosis (p=0.001 HR: 0.357 95% CI: 0.197 - 0.645) and time to HRPCa development (p=0.001 HR: 0.936 95% CI: 0.900 - 0.974) were significantly effective to the survival. Conclusion: PSADT, PSAV, and nadir PSA serve as independent prognostic markers for survival in patients with HRPCa. These three PSA derived calculation products, with the help of other parameters, could work as prognostic factors, and help clinicians predict survival in men with HRPCa. Key Words: PSA kinetics, Hormone-refractory prostate cancer, Survival, Prognostic factors.