Pak J Med Sci
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Understanding the epidemiology of upper gastrointestinal cancers in Pakistan may help in identifying important demographic risk factors for upper gastrointestinal malignancies in a particular rural population group. This will benefit in implementing tailored prevention approaches as well as effective management of health services. ⋯ The average age of patients undergoing upper gastrointestinal endoscopy among rural community of Karachi was relatively low. The burden of upper GI malignancies was significantly higher among elderly. Male patients had significantly greater burden of premalignant and malignant lesions as compared to females. No differences in the distribution of diagnostic outcomes were observed on the basis of ethnicity.
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Y chromosome abnormalities are common in male patients with severe oligo-azoospermia. In studies with karyotype analysis and cytogenetic methods, the importance of the Y chromosome in spermatogenesis has been well understood. Deletions in the azoospermia factor (AZF) localized at the distal end of the Y chromosome adversely affect the spermatogenesis process. Our objective was to determine the frequency of AZF microdeletion in azoospermia patients who underwent microTESE. ⋯ Poor sperm quality in AZF microdeletion patients complicates the selection of appropriate sperm for ICSI. Therefore, it leads to a decrease in embryonic development, fertilization and pregnancy results. In order to select the best sperm for the use in ICSI procedure in this patient population, intracytoplasmic morphologically selected sperm injection (IMSI) method can be preferred to improve the cycle outcomes.
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To determine that early needle-knife sphincterotomy does not increase post-ERCP pancreatitis in patients with difficult biliary cannulation as compared to standard cannulation. ⋯ NKS is an effective and safe modality for deep biliary cannulation and achieving technical success where cannulation is deemed difficult and does not increase the risk of PEP if done by experienced endoscopists in high volume centres.
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Enhanced Recovery after Surgery (ERAS) protocol has been developed and practiced for various surgical procedures to improve outcomes in the postoperative period. We hereby present our experience of ERAS for a large cohort of patients undergoing total joint arthroplasty (TJA). ⋯ ERAS protocol can bae effectively implemented for patients undergoing TJA. The use of ERAS leads to better postoperative outcomes and shortened hospital stay.
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To investigate the relationship between isocitrate dehydrogenase (IDH) 1/2 mutation, telomerase reverse transcriptase (TERT) gene promoter mutation and the prognosis of human glioma patients. ⋯ IDH1/2 gene and TERT promoter mutations are more frequent in patients with human glioma. These related factors can be used as molecular markers to aid in the prognosis of patients with glioma.