Notes

Characteristics associated with going around dendritic tissue and also cytokines after kidney transplantation-No aftereffect of remote control ischaemic fitness.
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To determine the frequency and predictors of outcome of gastrointestinal complications (GIC) in critically ill children.

This descriptive study was prospectively conducted in The Pediatric Intensive Care Unit (PICU), The Aga Khan University Hospital (AKUH), Karachi, from September 2015 to January 2017. After obtaining approval from the Ethical Review Committee of AKUH and informed consent from the parents, all children (aged one month to 18 years), of either gender, admitted to the Pediatric Intensive Care Unit (PICU) during the study period were included. The frequency of the defined GIC vomiting, high gastric residue volume (GRV), diarrhea, constipation, and gastrointestinal bleed were recorded daily for the first week of the PICU stay. The data was collected by the primary investigator on a predesigned data collection form with inclusion of variables and predictors in light of existing literature and local expertise. The questionnaire was shared with the Pediatric Critical Care Medicine faculty and a cedative drugs and the presence of shock with MODS were amongst the important contributing factors.
GI complications are a frequent occurrence in the PICU and are associated with worse clinical outcomes. The use of sedative drugs and the presence of shock with MODS were amongst the important contributing factors.
To investigate the role of concomitant Internal Limiting Membrane (ILM) peeling during surgery for macula off Rhegmatogenous Retinal Detachment (RRD) in preventing postoperative Epiretinal Membrane (ERM) formation; and its effect on the visual acuity.

This was a prospective, quasi-experimental study conducted from August 2018 to July 2019 at LRBT Tertiary Eye Care hospital, Karachi. Fifty-six patients with macula off RRD were divided into groups A (with ILM peeling) and B (without ILM peeling) via non-probability convenience sampling. All patients underwent standard 3 ports pars plana vitrectomy with silicon oil tamponade. In Group-A, ILM was stained using 0.5% ICG. Patients were evaluated clinically and by spectral domain optical coherence tomography (SD-OCT), pre- and post-operatively. Main outcomes recorded were best corrected visual acuity (BCVA) and occurrence of ERM on SD-OCT.

There were 26 patients in Group-A and 30 patients in Group-B. At six months' follow-up, ERM had not developed in any case in Group-A compared to five patients (16.7%) in Group-B. There was no statistical difference in mean BCVA change from baseline.

ILM peeling during vitrectomy for RRD prevents the formation of macular ERM post-operatively. This may reduce the need of a second vitrectomy. However, visual outcomes were comparable to the non-ILM peeling vitrectomy.
ILM peeling during vitrectomy for RRD prevents the formation of macular ERM post-operatively. This may reduce the need of a second vitrectomy. However, visual outcomes were comparable to the non-ILM peeling vitrectomy.
To explore the effect of risperidone combined with olanzapine in the treatment of schizophrenia and its influence on cognitive function.

Ninety-eight schizophrenic patients in our hospital who were admitted and treated between June 2018 and December 2019 were selected. The study group was treated with risperidone combined with olanzapine, and the control group was treated with risperidone. The clinical efficacy, Positive and Negative Syndrome Scale (PANSS) score, Wisconsin Card Sorting Test (WCST) result and adverse reactions of the two groups were compared.

After treatment, the scores of classification completion number and correct times of the observation group were higher than those of the control group, and the scores of the random error number and continuous error number were higher than those of the control group; the differences were statistically significant (P<0.05). The total effective rate of the observation group was 95.56%, which was higher than 77.78% of the control group (P<0.05). After treatment, the PANSS scores of the observation group were significantly lower than those of the control group (P<0.05). The total incidence of adverse reactions in the observation group and control group were 9.30% and 6.98%, respectively, and there was no significant difference between the two groups (P>0.05).

Risperidone combined with olanzapine in the treatment of schizophrenia can effectively reduce symptoms of patients and induce fewer adverse reactions, showing high safety and significant treatment effect.
Risperidone combined with olanzapine in the treatment of schizophrenia can effectively reduce symptoms of patients and induce fewer adverse reactions, showing high safety and significant treatment effect.
To analyze the management of severe necrotizing pancreatitis in a specialized center of a lower middle-income country, Pakistan using multiple outcome measures.

All the patients in this prospective observational study with severe necrotizing pancreatitis being referred to Pak Emirates Military Hospital from January 2017 to December 2019 were followed over the course of their admission. Demographic data and disease outcomes were duly noted. Cox regression analysis was used to predict fatality outcome.

A total of 57 patients with 48 (84.6%) infected necrotizing pancreatitis were managed in our set up. The most common etiology reported was gall-stones (37%) with male preponderance (72%) and a mean age of 50±11.3 years. selleckchem The most common complications were acute-kidney-injury (63%), splenic-vein-thrombosis (21%) and ascites (21%). Fourteen patients required mechanical-ventilation with a mean duration of 7±1.4 days on respiratory support. Eight (14%) patients required Endoscopic-Ultra-Sound guided drainage andned out to be an important procedure to manage infected pancreatic necrosis that helps to avoid a morbid procedure in the form of necrosectomy.
Understanding the demographics of mortality and its burden in the emergency department of a tertiary care setup can lead to better planning and allocation of resources to streamline process flow. This can be achieved systematically through mortality audit that can identify the loopholes and areas of improvement. Our objective was to characterize the epidemiology of ED mortality in a tertiary care hospital of Karachi, Pakistan.

A five-year retrospective chart review of 322 adult mortalities presenting between January l, 2014 - December 31, 2018 was conducted in the emergency department (ED) of The Indus Hospital (TIH), Karachi. All expiries in ED were included while those brought dead and with do not resuscitate order (DNAR) were excluded.

Mortality incidence of 0.076% (7.6/10,000 ED visits in five years) was reported. Amongst 507,759 adult ED visits, 322 mortalities were documented. Mean time lapse before presentation was 44±147 hours and mean length of stay before death was 3.4±2.8 hours. Acute coronary syndrome (ACS) was the predominant cause of death with 109 (33.
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