Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jan 2025
Meta AnalysisPeripheral Nerve Block Combined with Low-Dose General Anaesthesia in Elderly Patients Receiving Hip Arthroplasty.
The study assessed the effectiveness and safety of nerve block combined with low-dose general anaesthesia in elderly hip arthroplasty patients, conducted by a meta-analysis of RCTs. Six trials involving 403 patients were identified from databases such as Cochrane, MEDLINE, and PubMed. The results demonstrated a statistically significant difference in pain scores at postoperative 12hours (95% CI, -2.39 to -0.35, p = 0.008) and 24hours (95% CI, -1.86 to -0.50, p = 0.0007). ⋯ However, between the two groups, there was no statistically significant difference in the 48hour pain score (95% CI, -2.58 to 0.62, p = 0.23). Essentially, this approach effectively reduces early post-surgical pain and it minimises anaesthetic use, whilst simultaneously lowering the risk of complications. Key Words: Nerve block, Elderly patients, Hip arthroplasty, Pain, Postoperative complication.
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J Coll Physicians Surg Pak · Jan 2025
Randomized Controlled TrialLumbar Erector Spinae Plane Block Provides Effective Postoperative Analgesia in Hip Fracture Surgery.
To compare the postoperative analgesic effectiveness of ultrasound-guided lumbar erector spinae plane (LESP) block with lumbar plexus block (LPB) in patients operated for proximal femur fractures. ⋯ Lumbar erector spinae plane block, Lumbar plexus block, Ultrasound-guided, Hip surgery, Femur fracture, Postoperative analgesia.
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J Coll Physicians Surg Pak · Jan 2025
Influence of the Type of Bulk-Fill, Resin-Based Composite on Internal Adaptation in Class V Restorations.
To investigate the effects of bulk-fill, resin-based composite types (high or low viscosity) on the internal adaptation of Class V restorations. ⋯ Bulk-fill resin composite, Debonding formation, Artificial ageing, Optical coherence tomography, Class V.
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J Coll Physicians Surg Pak · Jan 2025
Neutrophil-to-Lymphocyte Ratio and System Score Could Predict the Occurrence of Macrophage Activation Syndrome in Patients with Adult-Onset Still's Disease.
To investigate the characteristics of Adult-onset Still's disease (AOSD) patients with macrophage activation syndrome (MAS) and explore the risk factors for the development of MAS. ⋯ Adult-onset still's disease, Macrophage activation syndrome, Risk factor.
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J Coll Physicians Surg Pak · Jan 2025
Gaps and Barriers to the Implementation of Antimicrobial Stewardship Programmes in Hospitals of Pakistan.
Antimicrobial-resistant bacteria are particularly prevalent in Southeast Asia, mainly due to inadequate infection prevention and control (IPC) and the widespread and uncontrolled use of antibiotics. Pakistan is the third largest low-middle-income country (LMIC) user of antibiotics. Antibiotic consumption increased by 65%, from 800 million to 1.3 billion defined daily doses (DDD). ⋯ Additionally, lack of support from hospital administration, limited nationwide health insurance coverage for bacterial cultures, and a lack of surgical centres and microbiology laboratories, information technology (IT) support to collect and analyse AS-related data, reduced availability of pharmacists, ID physicians, and IPC staff for ASP events are the primary contributing factors creating hindrance to the long-term viability of ASP. Briefly, strong hospital leadership support is the major factor for allocating the resources for ASP structures and activities and also for establishing the key performance indicators (KPIs), enforcing compliance with hospital-specific clinical practice guidelines, as well as addressing friction between ASP team members and prescribers. Key Words: Antimicrobial resistance, Antimicrobial stewardship programmes, Infection prevention and control.