OBJECTIVE:To benchmark machine-learning (ML) models for predicting postoperative infection after laparoscopic cholecystectomy (LC) in a real-world cohort. STUDY DESIGN:A descriptive study. Place and Duration of the Study: Department of General Surgery, Daqing People's Hospital, Daqing, China, from January 2016 to December 2025. METHODOLOGY:Consecutive patients undergoing LC were included. Postoperative infection was defined as a clinically diagnosed or culture-proven infection during index hospitalisation or within 30 days after surgery, using CDC/NHSN-based criteria where applicable. The cohort (n = 1,155; 186 infections) was randomly split into training (n = 816) and internal validation sets (n = 339). Four classifiers [decision tree (DT), support vector machine with a radial basis function kernel (SVM-RBF), random forest (RF), and naive Bayes (NB)] were developed. Performance was assessed using AUC, accuracy, sensitivity, and specificity at a prespecified probability threshold of 0.50, with precision-recall analysis, calibration, decision curve analysis, and permutation feature importance serving as complementary assessments. RESULTS:On validation, NB and RF showed the best discrimination (AUCs = 0.824 and 0.809, respectively), while DT and SVM-RBF performed poorly (AUCs = 0.614 and 0.582, respectively). At the 0.50 threshold, SVM-RBF predicted all validation patients as non-infected, indicating complete classification failure for clinical use. RF achieved high specificity (0.974) and accuracy (0.903), whereas NB yielded higher sensitivity (0.417). The highest-ranked RF predictors were preoperative white blood cell group, age, perioperative acute cholecystitis, the preoperative length-of-stay group, obesity, and operation duration group. CONCLUSION:ML models showed heterogeneous performance for predicting postoperative infection after LC. NB and RF performed best on internal validation and may support early risk stratification when paired with model interpretability, clinical utility assessment, external validation, and threshold optimisation. SVM-RBF was unsuitable for this dataset at the fixed 0.50 threshold. KEY WORDS:Laparoscopic cholecystectomy, Postoperative infection, Real-world cohort, Machine learning, Risk stratification.
OBJECTIVE:To evaluate the appropriateness of antibiotic dosing in patients with augmented renal clearance (ARC) admitted to the cardiovascular surgery intensive care unit (CVS-ICU) and the coronary intensive care unit (CICU). STUDY DESIGN:A descriptive study. Place and Duration of the Study: CVS-ICU and CICU, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkiye, from January 2024 to January 2025. METHODOLOGY:Adult patients (≥18 years) hospitalised for ≥24 hours, diagnosed with ARC (eGFR ≥130 mL/min/1.73 m2), and receiving antibiotics were included. Dosing appropriateness was assessed based on UpToDate® recommendations. ARC risk was stratified using the ARC scoring system. Data were analysed using descriptive statistics, chi-square test, and Mann-Whitney U test. RESULTS:Of the 3,334 screened patients, 83 (2.5%) met ARC criteria; 57 received antibiotics and were included in the analysis. At least one dosing error was identified in 84.2% of cases, mostly underdosing (73.1%). The most common antibiotics were cefazolin (42.6%), ampicillin-sulbactam (14.6%), and daptomycin (7.3%). A high ARC risk score was associated with a greater likelihood of dosing errors (90.4% vs. 66.6%; OR = 4.7, p = 0.044). Patients with dosing errors were younger (median 25.5 vs. 50 years, p = 0.004) and received more antibiotics (p = 0.038). CONCLUSION:Although ARC was uncommon, dosing errors were frequent. Early recognition of ARC and individualised dosing are critical to optimise therapy in ICU patients. KEY WORDS:Augmented renal clearance, Antibiotic dosing, Cardiovascular surgery intensive care unit, Coronary intensive care unit, Dose adjustment.
OBJECTIVE:To evaluate the distribution of cancers across different age groups among residents of Balochistan from 2021 to 2024 and compare these patterns with those observed in other provinces of Pakistan. STUDY DESIGN:An observational study. Place and Duration of the Study: Pathology-based cancer registry at the Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan, and Department of Pathology, Aria Institute of Medical Sciences, Quetta, Pakistan, from January 2021 to December 2024. METHODOLOGY:Newly diagnosed, biopsy-confirmed malignant cases received from Quetta and other cities of Balochistan through the Aga Khan University Hospital laboratory network and the collaborating Institute over four years from the cancer registry and one year from the other institute were analysed. Patients were grouped by age and gender into children (0-14 years), adolescents (15-19 years), and adults (≥20 years). Duplicate records were removed through systematic verification. Categorical variables were evaluated using frequencies and percentages. RESULTS:Out of 16,342 biopsy specimens, 5,145 (31.5%) were malignant. There were 52% (n = 2,659) male and 48% (n = 2,486) female cases. Adults accounted for 93% of cases, while children and adolescents accounted for 7%. Among a total of 2,438 adult males, oesophageal cancer was most frequent (425, 17.4%), followed by stomach (351, 14.4%) and colorectal cancers (225, 9.2%). Out of the total 2,351 adult females, breast cancer was the leading malignancy (526, 22.4%), followed by oesophageal (434, 18.5%) and colorectal cancers (133, 5.7%). In younger groups, brain tumours and lymphomas predominated. CONCLUSION:Marked predominance of oesophageal cancer in both genders highlights substantial regional variation. Overall, the predominance of gastrointestinal cancers suggests the presence of region-specific environmental risk factors. KEY WORDS:Cancer registry, Balochistan, Oesophageal cancer, Colorectal cancer.
OBJECTIVE:To determine the relative frequency of conditions causing different types of fibrosis [usual interstitial pneumonia (UIP) and non-specific interstitial pneumonia (NSIP)] in combined pulmonary fibrosis and emphysema (CPFE), a newly defined disease. STUDY DESIGN:A cross-sectional observational study. Place and Duration of the Study: Department of Radiology, Tokat Gaziosmanpasa University, Tokat, Turkiye, from January 2023 to January 2025. METHODOLOGY:Based on HRCT images, the visualised fibrosis types were divided into two groups: UIP (n = 48) and NSIP (n = 46). Demographic data included age, gender, smoking history, and occupational history. The Charlson Comorbidity Index (CCI) score was calculated for each patient. The Kolmogorov-Smirnov test was used to assess the distribution of variables in the analyses. Categorical data were compared using the chi-square test and numerical data by Student's t-test. RESULTS:CPFE patients were divided into two groups: UIP pattern (n = 48) and NSIP pattern (n = 46). No significant differences were found between the groups in terms of age, gender, smoking, CCI, and high-risk occupation. When examining the relationship between pulmonary hypertension and demographic data in patients with CPFE, the mean age and CCI were significantly higher in the group with systolic pulmonary artery pressure (sPAP) ≥25 mmHg, as measured by echocardiography. Furthermore, in those with sPAP ≥25, haemoglobin and haematocrit levels were significantly lower, and urea levels were significantly higher. Similarly, in those with sPAP ≥25, diffusing capacity of the lungs for carbon monoxide levels were significantly lower. CONCLUSION:Although comorbidities were found to be significantly higher in the UIP pattern compared to the NSIP pattern, the CCI was similar. As more than half of patients with CPFE had elevated sPAP, pulmonary hypertension should also be considered when evaluating these patients. KEY WORDS:Pulmonary fibrosis, Emphysema, Usual interstitial pneumonia, Carbon monoxide, Diffusion test, Pulmonary artery pressure.
OBJECTIVE:To evaluate the association between refined CD4+ T-lymphocyte count stratification and 30-day and 180-day all-cause mortality in human immunodeficiency virus (HIV)-associated pulmonary cryptococcosis (PC), thereby supporting risk stratification and treatment optimisation. STUDY DESIGN:A descriptive analytical study. Place and Duration of the Study: Department of Respiratory and Critical Care Medicine, Beijing Youan Hospital, Capital Medical University, Beijing, China, from September 2020 to June 2025. METHODOLOGY:Ninety-eight patients with HIV-associated PC were stratified into four groups by baseline CD4+ T-lymphocyte counts, with mortality at 30 and 180 days as the primary outcomes. Kaplan-Meier analysis and multivariable and piecewise Cox regression were used to assess the association between CD4+ T-lymphocyte count stratification and mortality, with discrimination evaluated using the area under the curve (AUC) of the receiver operating characteristic curve (ROC) and Brier scores. Statistical analyses were performed using SPSS, R software, and GraphPad Prism. RESULTS:In HIV-associated PC, 30-day and 180-day all-cause mortality varied significantly across CD4+ T-lymphocyte count strata, with progressively lower mortality among patients with higher CD4+ T-lymphocyte counts (30-day: Log-rank p = 0.016, trend p = 0.004; 180-day: Log-rank p = 0.008, trend p = 0.002). Refined CD4+ T-lymphocyte count stratification was a predictor of 30-day and 180-day mortality in HIV-associated PC (30-day: HR = 0.10, 95% CI: 0.01-0.96, p = 0.046; 180-day: HR = 0.31, 95% CI: 0.12-0.81, p = 0.017). C-reactive protein (CRP) levels, coexisting cryptococcal meningitis (CM), and combination antifungal therapy showed time-dependent effects, primarily within 30 days. The multivariable model demonstrated superior discrimination for both 30-day and 180-day mortality compared with the model based solely on CD4+ T-lymphocyte count strata. CONCLUSION:Lower refined baseline CD4+ T-lymphocyte count strata are associated with higher 30-day and 180-day mortality in HIV-associated PC and may help guide risk assessment and treatment decision-making. KEY WORDS:Human immunodeficiency virus, Pulmonary cryptococcosis, CD4+ T-lymphocyte count stratification, Mortality.
OBJECTIVE:To evaluate the expression of Fascin-1 in colorectal carcinoma and analyse its association with clinicopathological parameters and pathological stage. STUDY DESIGN:A cross-sectional Study. Place and Duration of the Study: Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, from July 2022 to June 2023. METHODOLOGY:Surgical resection specimens of colorectal carcinoma underwent histopathological processing for the preparation of haematoxylin and eosin-stained slides. Immunohistochemical evaluation for the biomarker Fascin-1 was then performed, and its expression was evaluated according to standard criteria. RESULTS:There was a total of 73 cases of colorectal cancer in this study. The mean age of patients was 44.76 ± 15.83 years (13-75 years). Histopathological subtype adenocarcinoma NOS was the most common finding on microscopic examination. Moderately differentiated tumours were the most frequent finding (63%, n = 46). In this study, most tumours were of the rectosigmoid region (26%, n = 19). Fascin-1 had positive expression in 46.6% (n = 34) cases. In histopathologic subtype, poorly differentiated tumours had a statistically significant expression of Fascin-1 (p = 0.001). ROC curve analysis of the continuous Fascin-1 product score against pathological stage demonstrated excellent predictive performance (AUC = 0.859, p <0.001). Multivariate analysis demonstrated higher expression of Fascin-1 to be a significant predictor of advanced stage (OR = 6.131, 95% CI: 1.197-31.410; p = 0.030). However, lymphovascular invasion (p = 0.082), tumour deposits (p = 0.798), and tumour grade (p = 0.315) did not show a significant association with advanced stage. CONCLUSION:Fascin-1 expression is significantly associated with advanced tumour stage in colorectal carcinoma. Independent association of Fascin-1 with staging in multivariate analysis suggests its potential role as a biomarker for tumour progression. Its higher expression in poorly differentiated tumours and signet ring cell carcinoma also supports its role in tumour aggressiveness. KEY WORDS:Colorectal neoplasms, Fascin-1, Immunohistochemistry, Neoplasm grading, Neoplasm staging.
OBJECTIVE:To evaluate the diagnostic performance of the Impacted Stone Formula (ISF) in a South Asian cohort undergoing semirigid ureteroscopy (URS). STUDY DESIGN:An analytical study. Place and Duration of the Study: Department of Urology, Aga Khan University Hospital, Karachi, Pakistan, from March to September 2025. METHODOLOGY:This study included 120 adult patients who underwent semirigid URS for a single, unilateral, radio-opaque ureteric stone at Aga Khan University Hospital, Karachi, Pakistan. Preoperative non-contrast computed tomography (NCCT) parameters, including stone characteristics, ureteric wall thickness (UWT), hydronephrosis grade, and Hounsfield unit (HU) measurements proximal and distal to the stone, were recorded and analysed using SPSS. ISF was calculated using the validated formula: ISF = UWT × (HU below/HU above) × (1 + hydronephrosis grade). Stone impaction was confirmed intraoperatively by failure to pass a guidewire beyond the stone during initial ureteral catheterisation. The cut-off value for ISF was determined using the Youden Index. Receiver operating characteristic (ROC) analysis and multivariable logistic regression were performed to assess predictive accuracy. RESULTS:Among 120 patients, 57 (47.5%) had impacted stones. Impacted stones were associated with significantly higher UWT, hydronephrosis grades, stone density, and ISF values. ROC analysis demonstrated excellent discriminatory performance of the ISF with an area under the curve of 0.96. At a cut-off value of 15.5, ISF showed 75% sensitivity and 93.7% specificity. Impacted stones were associated with longer operative times, increased intraoperative bleeding, longer length of stay, and higher postoperative stent placement rates. CONCLUSION:The ISF is a reliable and practical preoperative predictor of ureteric stone impaction. Incorporation of ISF in routine practice, along with NCCT assessment, may improve surgical planning, risk stratification, and patient counselling before the procedure. KEY WORDS:Urolithiasis, Stone impaction, Ureteroscopy, Ureteral wall thickness, Prognostic factor, Validation.
Pakistan faces an escalating cancer burden, with approximately 185,748 new cases and 118,631 deaths annually. According to GLOBOCAN data, breast cancer (16.5%), lip/oral cavity cancer (8.6%), and lung cancer (5.1%) are the most prevalent, with breast cancer alone accounting for 31.3% of female cases. The country's limited healthcare resources, including severe shortages of oncologists and radiotherapy facilities, exacerbate this crisis, requiring urgent intervention. The delta Mortality-to-Incidence Ratio (dMIR) metric identifies cancers with the largest outcome gaps between Pakistan and top-performing countries, highlighting where improvements could yield the greatest impact. For instance, stomach cancer (dMIR = 0.60), Kaposi sarcoma (0.58), and oral cavity cancer (0.49) represent critical priorities. By focusing resources on high-dMIR cancers through early detection, treatment access, and prevention programs, Pakistan can significantly reduce preventable mortality. To address these challenges, Pakistan must implement a comprehensive National Cancer Control Plan. Key steps include expanding screening programs for breast, cervical, and oral cancers; training healthcare workers; upgrading radiotherapy infrastructure; and launching public awareness campaigns targeting tobacco use and lifestyle risks. Strategic investments in these areas, coupled with policy reforms and public-private partnerships, could transform cancer outcomes in Pakistan. Key Words: Pakistan, Cancer burden, Delta mortality-to-incidence ratio, Cancer disparities, Low- and middle-income countries.
This cross-sectional study aimed to compare serum Retinol-Binding Protein 4 (RBP4) levels in hypertensive and normotensive non-obese individuals. A total of 41 hypertensive and 41 normotensive subjects aged ≥40 years were enrolled. Hypertension was defined as a blood pressure (BP) of ≥140/90 mmHg, whereas normotension was defined as a BP of <120/80 mmHg in the absence of antihypertensive medication (JNC 8 criteria). Five millilitres of venous blood were collected aseptically, and serum RBP4 was measured using a Human RBP4 ELISA kit. Data were analysed using SPSS version 26 with an independent sample t-test; p ≤0.05 was considered statistically significant. Forty-six per cent of participants were male, with a mean age of 53.69 ± 9.86 years in the hypertensive and 52.41 ± 6.30 years in the normotensive group. The mean serum RBP4 was significantly higher in the hypertensive group (62.17 ± 28.22 ng/mL) than in the normotensive group (14.70 ± 5.59 ng/mL), suggesting its potential as a biomarker. Key Words: Hypertension, Normotensive, Serum Retinol-binding Protein-4, Cardiovascular diseases.
OBJECTIVE:To develop and evaluate a deep learning approach for the automated segmentation of impacted third molars on cone-beam computed tomography (CBCT) images and the classification of each tooth's root apex as open or closed. STUDY DESIGN:An observational study. Place and Duration of the Study: Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Marmara University, Istanbul, Turkiye, from December 2022 to December 2024. METHODOLOGY:Three hundred CBCT scans containing impacted third molars were retrospectively collected. Experts categorised teeth as having an open apex (incomplete root development) or closed apex (fully formed roots). A 3D nnU-Net convolutional neural network was trained using manual segmentations of the molars (270 scans for training and 30 for testing), with the network output distinguishing between teeth with open and closed apices. Model performance was evaluated on the independent test set using segmentation overlap metrics (Dice similarity coefficient and Jaccard index) and classification metrics derived from confusion matrix components [accuracy, sensitivity, precision, and area under the ROC curve (AUC)]. All performance metrics were automatically computed within the nnU-Net v2 framework and further verified using Python. RESULTS:The model demonstrated high performance in segmenting closed-apex molars, achieving a Dice similarity coefficient of 0.85, a Jaccard index of 0.78, sensitivity of 0.90, precision of 0.85, and an AUC of 0.95. However, for open-apex molars, performance was substantially lower (Dice: 0.37; Jaccard: 0.30; sensitivity: 0.31; precision: 0.71; AUC: 0.65), primarily attributable to severe class imbalance in the training dataset. CONCLUSION:This study demonstrates the feasibility of a deep learning approach for automatically evaluating impacted third molars on CBCT, including tooth segmentation and root maturity assessment. The model's strong performance suggests that such AI tools could assist clinicians in assessing impactions and planning extractions. KEY WORDS:Impacted third molar, Cone-beam computed tomography, Deep learning, Tooth segmentation, Root apex closure, nnU-Net.
OBJECTIVE:To quantify the proportion of cribriform pattern in Gleason score (GS) 7 prostate cancer (PCa) and evaluate its association with established pathological parameters. STUDY DESIGN:An analytical study. Place and Duration of the Study: Department of Histopathology, Liaquat National Hospital and Medical College, Karachi, Pakistan, from January 2023 to July 2025. METHODOLOGY:The study included 44 cases of prostatic adenocarcinoma (Grade Groups 2 and 3 [GG2 and GG3]). All histological slides were independently reviewed by two expert histopathologists. The percentage of Gleason pattern 4 (GP4) in GG2 and GG3 tumours and the presence of cribriform architecture were recorded. Cribriform pattern was categorised as absent, <20%, or ≥20%. Associations with GG, intraductal carcinoma, tertiary pattern 5, perineural invasion (PNI), lymphovascular invasion, and tumour volume were analysed using Fisher's exact test. RESULTS:The mean age of patients was 68.4 ± 10.8 years. Cribriform architecture was identified in 23 (52.2%) cases, with ≥20% cribriform pattern in 8 (18.2%) cases. A significant association was observed between a cribriform pattern ≥20% and PNI (p = 0.047), higher GG (GG3) (p = 0.032), and an increasing GP4 burden in both GG2 and GG3 tumours (p = 0.041 and p = 0.038, respectively). No significant associations were found with other parameters. Subgroup analyses within individual GGs did not show statistically significant associations. CONCLUSION:Cribriform GP4 is frequent in GS 7 PCa. It correlates with adverse pathological features. Routine reporting of cribriform architecture may refine risk stratification and provide more personalised management of patients with intermediate-risk PCa. KEY WORDS:Cribriform pattern, Gleason score, Histopathology, Prostate cancer.
OBJECTIVE:To explore the association between comprehensive geriatric assessment (CGA)-related projects and indicators of heart failure with preserved ejection fraction (HFpEF) in hospitalised older adults, and to evaluate their predictive value for HFpEF risk. STUDY DESIGN:An observational study. Place and Duration of the Study: Department of Geriatrics, Mindong Hospital Affiliated to Fujian Medical University, Mindong, China, from July to December 2024. METHODOLOGY:A total of 134 patients aged ≥60 years who received standard CGA were included in the single-centre cross-sectional analysis. The CGA protocol was used to evaluate frailty using the FRAIL scale, sarcopenia risk using the SARC-CalF score, nutritional status, cognitive function, basic activities of daily living, and fall risk. Patients were divided into the HFpEF group (n = 50) and the heart failure without preserved ejection fraction (non-HFpEF) group (n = 84) according to clinical diagnosis. Statistical methods included initial univariate screening, variable selection using Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis to evaluate diagnostic performance. RESULTS:Patients with HFpEF were older, had a higher burden of polypharmacy, and had higher FRAIL scores than those in the non-HFpEF group (all p <0.05). In the adjusted multivariate analysis, both FRAIL and SARC-CalF scores were independently associated with HFpEF. The odds ratio for the FRAIL score was 3.68 (95% CI, 1.83-8.39), while the odds ratio for the SARC-CalF score was 1.47 (95% CI, 1.21-1.86). ROC analysis shows that the prediction utility of the two tools is relatively strong. The AUC for the FRAIL scale is 0.88, whereas the AUC for the SARC-CalF scale is 0.89. The optimal diagnostic thresholds are 1.5 points (indicating pre-frailty) and 11 points. CONCLUSION:The SARC-CalF and FRAIL scales are sensitive for identifying high-risk older adults with HFpEF. Their combined use improves predictive specificity and accuracy compared with either scale alone. This dual-scale approach may provide a practical and efficient preliminary screening tool for HFpEF in geriatric care. KEY WORDS:HFpEF, Comprehensive geriatric assessment, Aged, Frailty, Pre-frailty, Sarcopenia.
OBJECTIVE:To compare the efficiency and safety of torsional Intelligent Phaco (IP) mode with those of the combined torsional- longitudinal mode for the treatment of Grade 5 cataracts. STUDY DESIGN:A descriptive study. Place and Duration of the Study: Department of Ophthalmology, Medicana International Izmir Hospital, Turkiye, from January 2020 to July 2025. METHODOLOGY:Patients with Grade 5 cataracts who underwent torsional IP mode and combined torsional-longitudinal mode were retrospectively analysed. Age, gender, operation time, ultrasound time, cumulative dissipated energy (CDE), longitudinal power, torsional amplitude, and total estimated fluid were recorded. Preoperative and postoperative best-corrected visual acuity (BCVA) and central corneal thickness were noted. RESULTS:A total of 68 patients were included. Ultrasound time was significantly shorter in the combined torsional-longitudinal US mode group than in the torsional IP mode group (76.1s vs. 67.9s, p = 0.008). The mean CDE (22.1 vs. 18.9, p = 0.001) and torsional amplitude (60.0 vs. 55.8, p = 0.003) were significantly higher in the torsional IP mode group. Single and multiple occlusions were detected in 9 and 13 patients in the IP torsional mode group, and 6 patients and 2 patients in the combined torsional-longitudinal US mode group, respectively. Conclusion: The present study demonstrated that both torsional IP mode and combined torsional-longitudinal US mode are effective and safe techniques for the management of Grade 5 cataracts. However, the combined mode was associated with shorter ultrasound time, lower CDE, lower torsional amplitude, and fewer intraoperative occlusions. Key Words: Cataract, Torsional-longitudinal mode, Torsional IP mode, Phacoemulsification.
OBJECTIVE:To determine the association of obstructive sleep apnoea (OSA) severity with nocturnal blood pressure patterns, blood pressure variability (BPV), and heart rate variability (HRV) in patients with hypertension. STUDY DESIGN:An observational study. Place and Duration of the Study: Cardiac Function Laboratory, Department of Cardiology, Xianning Central Hospital, the First Affiliated Hospital of Hubei University of Science and Technology, Xianming, China, from January 2024 to May 2025. METHODOLOGY:Adult hypertensive patients who underwent polysomnography (PSG) were analysed. OSA severity was defined by the apnoea-hypopnoea index (AHI). Available ambulatory blood pressure monitoring (ABPM) and Holter data were used to assess nocturnal systolic blood pressure (SBP) fall, non-dipping, BPV, and HRV. Group comparisons were performed using the Kruskal-Wallis test, the chi-square test, or Fisher's exact test, as appropriate. Spearman's correlation and regression analyses were performed where appropriate. RESULTS:Eighty-six patients comprised the PSG cohort; 44 had ABPM data, and 60 had HRV data. Body mass index differed across OSA severity categories (severe OSA: 30.00 [27.92-33.60] kg/m2; p = 0.001). In the ABPM+PSG sub-cohort, nocturnal SBP fall showed a decreasing trend with increasing OSA severity (severe OSA: 2.43 [-1.89 to 7.68%]; p = 0.105). For every 10 events/hour increase in the AHI, nocturnal SBP increased after adjustment (β = 3.63, 95% CI 0.42-6.83; p = 0.032). CONCLUSION:Greater OSA severity was associated with higher nocturnal SBP and possible autonomic imbalance. ABPM with OSA screening may help identify high-risk nocturnal blood pressure phenotypes in hypertensive patients. KEY WORDS:Obstructive sleep apnoea, Hypertension, Ambulatory blood pressure monitoring, Circadian rhythm, Blood pressure variability, Heart rate variability.
