Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Oct 2023
Relationship of End Expiratory Lung Volume, Compliance, and Plateau Pressure in Acute Respiratory Distress Syndrome.
COVID-19 ARDS (acute respiratory distress syndrome), caused by SARS-CoV-2, involves a decrease in the end expiratory lung volume (EELV), compliance, and hypoxemia. The authors retrospectively analysed the relationship between the EELV, Plateau pressure (Pplat), and compliance of the respiratory system in a group of 21 mechanically ventilated COVID ARDS patients with moderate to severe hypoxia who were subjected to a recruitment manoeuvre. Further, these parameters were studied after dividing them into two groups as Group 1 of clinically non-recruitable and Group 2 of clinically recruitable patients. There was relationship between EELV, compliance, and Pplat among those patients who were clinically recruited versus those who were not in a homogeneous group of COVID ARDS patients. ⋯ In Group 2, the statistical values of EELV and compliance were (r = 0.605, p<0.001), EELV and Pplat were r = -0.391, p<0.05, compliance and Pplat were r = -0.848, p<0.001. The additional information gained after understanding this relationship can help to optimise ventilator settings. Key Words: COVID, ARDS, End expiratory lung volume, Plateau pressure, Compliance, Recruitment, Ventilation.
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J Coll Physicians Surg Pak · Oct 2023
Meta AnalysisDiagnostic Performance and Accuracy of Strain Elastography for BI-RADS Category 4 Lesions among Asian Females.
This work aimed to assess the diagnostic performance of strain elastography (elasticity score) and its accuracy for breast BI-RADS category 4 lesions. Online databases including Cochrane Library, Embase, PubMed, and Web of Science were searched for eligible articles published prior to March 10, 2022. The pooled effect indicators including sensitivity, specificity, positive and negative likelihood ratios (PLR, NLR), the area under the summary receiver operating characteristic (SROC) curve, and diagnostic odds ratio (DOR) were utilised to assess the strain elastography's performance in diagnosing BI-RADS category 4 lesions. ⋯ No significant publication bias was detected. Taken together, strain elastography had suboptimal sensitivity but desirable specificity for the accurate diagnosis of BI-RADS category 4 lesions among Asian females, which can help avoid unnecessary biopsies and reduce patient anxiety. Key Words: BI-RADS category 4 lesions, Strain elastography, Meta-analysis.
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J Coll Physicians Surg Pak · Oct 2023
Randomized Controlled Trial Comparative StudyEffect of Preventive Nursing on Male Children with Hypospadias in Preventing Postoperative Complications.
To determine the clinical impact of preventive nursing on children with hypospadias and the intervention effect on postoperative complications. ⋯ Preventive care, Hypospadias in male children, Urethroplasty, Complication, Clinical effect.