Dr. Ruth K. M. Pfau Civil Hospital Karachi, commonly known as Civil Hospital Karachi, is a 1,900-bed tertiary care public hospital that imparts both undergraduate and postgraduate teaching and training.It is one of the teaching hospitals affiliated with the Dow Medical College, Karachi. Ruth K. Ruth K. Ruth K. Ruth K.
High-quality care in obstetrics and gynecology (OBGYN) is closely linked to patient satisfaction. However, disparities in care delivery based on patient demographics, including gender, race, and ethnicity, have been documented in the literature. As healthcare institutions strive to improve the quality of care provided to their patients, diversity among gynaecologists is emerging as essential to achieving this goal. Increasing diversity among gynaecologists can lead to better representation of diverse patient populations and improved patient-physician concordance, resulting in higher patient satisfaction. Available evidence shows that there are high levels of disparity in workforce in the field of OBGYN. An example can be provided with women in the United States who make up about 57
OBJECTIVE: To analyze serum metal concentrations in oral cancer (OC) patients and healthy controls, investigating their interrelationship and potential diagnostic and clinical significance. METHODOLOGY: This case-control study was conducted at the Institute of Biochemistry, University of Sindh, Jamshoro, with sample collection from the Liaquat University of Medical & Health Sciences (LUMHS) from May 2023 to February 2024. 145 Newly diagnosed OC patients without prior radiotherapy or chemotherapy, capable of understanding and answering questions and 145 age and gender-matched individuals from the same hospital with no personal or family history of cancer were included in the study. 5 mL of blood was collected from the participants for metal analysis. Blood samples were used to analyze serum metal levels by inductively coupled plasma-optical emission spectroscopy (ICP-OES). Data analysis was performed using SPSS version 20.0, employing statistical tests to compare serum metal levels between patients and controls and among different demographic groups. RESULTS: The study presents a detailed comparison of trace element concentrations between OC patients and controls, highlighting significant differences in metals such as aluminum (Al), arsenic (As), cobalt (Co), chromium (Cr), cadmium (Cd), copper (Cu), manganese (Mn), nickel (Ni), iron (Fe), selenium (Se), lead (Pb), strontium (Sr), and zinc (Zn). Gender-wise comparisons also reveal variations in metal concentrations, suggesting potential differential exposure or metabolic processing between males and females. CONCLUSION: Understanding the mechanisms underlying metal-related cancer development could help improve diagnostic and therapeutic strategies for OC patients.
Abstract Gallstones represent a widespread digestive system condition globally, predominantly manifesting as cholesterol-based calculi. Historical understanding has focused on metabolic and liver-biliary mechanisms as primary causative factors; recent research, however, increasingly demonstrates that intestinal microbial communities significantly contribute to gallstone development. The gut microbiome affects bile acid (BA) processing, cholesterol regulation, and the enterohepatic cycle. Microbial imbalances may lead to modifications in BA composition and inflammatory responses, increasing susceptibility to stone formation. This article consolidates existing research examining how intestinal bacteria influence gallstone pathogenesis, underlying biological mechanisms, clinical relevance, and potential treatment strategies.
Complete esophageal obstruction (CEO) is a rare complication of chemoradiotherapy for head and neck cancers. We report 2 cases of radiation-induced CEO in the upper esophagus, managed with combined antegrade and retrograde endoscopic dilatation (CARD). In 1 case, percutaneous endoscopic gastrostomy (PEG) dependence was eliminated, and swallowing was improved to a soft diet. In the second case, recurrence required repeat CARD, resulting in partial swallowing recovery but persistent PEG dependence. Both procedures were technically successful without major complications. These cases illustrate that CARD is a safe and effective alternative to surgery in CEO, even in technically challenging sites, enhancing quality of life, although recurrence remains a concern.
Background Effective pain management during and after surgery is essential for improving patient outcomes. Adding adjuvants like clonidine to local anesthetics enhances block efficacy and improves post-operative analgesia. Objective To evaluate the efficacy and safety of adding low-dose clonidine (0.5 mcg/kg) to 0.2% ropivacaine in ultrasound-guided supraclavicular brachial plexus block for upper limb surgeries by assessing the duration of postoperative analgesia, pain intensity, time to first pain complaint, time to requirement of rescue analgesia, and the influence of demographic variables (age and gender) on analgesic efficacy and duration. Methods A prospective observational study included 90 patients undergoing upper limb surgery. Group A (n=45) received ropivacaine, while Group B (n=45) received the same with clonidine. Pain was assessed using the Visual Analog Scale (VAS) at 0, 6, 12, and 24-48 hours postoperatively. Primary outcomes were the duration of analgesia, time to the first pain complaint, and VAS scores. Statistical analysis was done using SPSS, version 29 (p<0.05). Results Group B showed a significantly longer duration of analgesia (14.33±0.91 hours) compared to Group A (6.96±1.13 hours, p<0.001). VAS scores at 6 and 12 hours were significantly lower in Group B (p<0.001). No significant adverse effects were noted. Conclusion Adding clonidine to ropivacaine in supraclavicular brachial plexus blocks significantly prolongs analgesia and reduces pain scores without notable side effects, demonstrating it as an effective strategy for improving patient comfort.
