Journal of the College of Physicians and Surgeons--Pakistan: JCPSP (JCPSP-J COLL PHYSICI )

Publisher: College of Physicians and Surgeons (Pakistan)

Description

  • Impact factor
    0.30
  • 5-year impact
    0.34
  • Cited half-life
    5.70
  • Immediacy index
    0.05
  • Eigenfactor
    0.00
  • Article influence
    0.09
  • Website
    Journal of the College of Physicians and Surgeons (Pakistan) website
  • Other titles
    Journal of the College of Physicians and Surgeons--Pakistan (Online), JCPSP
  • ISSN
    1022-386X
  • OCLC
    60648728
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 12/2014; 24(12):956.
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    ABSTRACT: Objective: To determine the clinico-pathological and histological features of Chondroblastoma (CB). Study Design: Case series. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from 2000 to 2013. Methodology: The histological slides of all reported cases of CB were retrieved and reviewed for morphological features. Clinical features were noted from surgical pathology reports. Frequency of features was noted. Results: Sixty one cases of CB were identified. Pain was the most common presenting symptom. The age ranged from 10 to 38 years (mean 20 ± 1.98 years; M: F 2.5:1) with 61% patients in the second decade of life. Forty six cases occurred in long tubular bones; distal femur being most common site. Metaphysis, clavicle, temporal bone and metacarpal were also involved. Histologically, all CBs were composed of round to polygonal cells and scattered osteoclast-type multinucleated giant cells and majority had hemosiderin pigment. Chicken-wire calcifications and coarse calcifications were seen in 85% and 26% of cases respectively. A spindle cell component was seen in 54% of cases. ABC-like areas were seen in 10 cases. Mitosis ranged from 1 to 6/10 HPFs. Recurrence was seen in 2 cases. Recurrent tumor showed similar morphology when compared with the initial tumor. Conclusion: CB is a benign tumor but has potential for recurrence. Males are more affected, second decade is more common and distal femur is most common site. Metaphysis, clavicle, temporal bone and metacarpal were the rare sites of CB. Histological features predictive of recurrence were not separately identified.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 12/2014; 24(12):98-901.
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    ABSTRACT: Objective: To compare Greulich-Pyle (GP) and Girdany-Golden (GG) methods for estimation of Skeletal Age (SA) in children referred to a tertiary care hospital in Karachi, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Radiology, The Aga Khan University Hospital, Karachi, Pakistan, from July 2010 to June 2012. Methodology: Children up to the age of 18 years, who had undergone X-ray for the evaluation of trauma were included. Each X-ray was interpreted using both methods by two consultant paediatric radiologists having at least 10 years experience, who were blinded to the actual Chronologic Age (CA) of children. Results: A total of 283 children were included. No significant difference was noted in mean SA estimated by GP method and mean CA for female children (p=0.695). However, a significant difference was noted between mean CA and mean SA by GG method for females (p=0.011). For males, there was a significant difference between mean CA and mean SA estimated by both GP and GG methods. A stronger correlation was found between CA and SA estimated by GP method (r=0.943 for girls, r=0.915 for boys) as compared to GG method (r=0.909 for girls, r=0.865 for boys) respectively. Bland-Altman analysis also revealed that the two methods cannot be used interchangeably. Excellent correlation was seen between the two readers for both GP and GG methods. Conclusion: There was no additional benefit of using GP and GG methods simultaneously over using GP method alone. Moreover, although GP was reliable in estimating SA in girls, it was unable to accurately assess SA in boys. Therefore, it would be ideal to develop indigenous standards of bone age estimation based on a representative sample of healthy native children.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 12/2014; 24(12):889-893.
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    ABSTRACT: To determine the efficacy of clarithromycin in the treatment of Pityriasis Rosea (PR). Double blind randomized controlled trial. Dermatology OPD, Military Hospital, Rawalpindi, from July 2008 to July 2009. Patients aged above 10 years, diagnosed with PR, were randomly assigned to two groups of 30 each to receive either clarithromycin or similar-looking placebo for one week. Neither the patient nor the treating physician knew to which group the patient belonged. Patients were assessed at 1, 2, 4 and 6 weeks after presentation and compared for complete, partial or no response. Among the 60 patients, no significant difference was found between the two groups at 2 weeks after presentation (p = 0.598). In the placebo group, complete response was seen in 20 (66.7%), partial response in 3 (10.0%) while no response was seen in 7 (23.3%). In clarithromycin group, there was complete response in 23 (76.7%), partial response in 3 (10.0%) and no response in 4 (13.3%) patients. Clarithromycin is not effective in treatment of pityriasis rosea.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):802-5.
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    ABSTRACT: To validate a cheaper and more accessible flow cytometry-based method of assessing Asialoglycoprotein Receptor (ASGPR) expression for hepatic functional reserve. A retrospective analysis. Beijing Ditan Hospital, Capital Medical University, Beijing, from January 2011 to October 2013. Patients with Hepatocellular Carcinoma (HCC) undergoing major hepatectomy at Beijing Ditan Hospital, during the study period were retrospectively studied. The fraction of hepatocytes expressing ASGPR in liver tissues was assessed by flow cytometry. Patients were grouped according to the presence or absence of postoperative hepatic dysfunction. The correlation between ASGPR expression and pre-operative liver function parameters with the outcomes of hepatectomy were analyzed. Fewer hepatocytes from patients with postoperative hepatic dysfunction expressed ASGPR [63.3 (57.3 - 68.2)] than from patients without postoperative hepatic dysfunction [72.4 (70.6 - 76.3), p < 0.001]. Multiple logistic regression demonstrated ASGPR levels to be independently correlated with postoperative hepatic dysfunction (Odds ratio 3.34, 95% CI: 2.61-6.02, p < 0.001), and the Receiver Operating Characteristic (ROC) curve for prediction of postoperative liver dysfunction at ≤ 68.95% ASGPR+ hepatocytes achieved a sensitivity of 100% and specificity of 90.6%. The ROC curve for prediction of postoperative liver failure related death at ≤ 58.53% ASGPR+ hepatocytes achieved a sensitivity of 100% and specificity of 99%. Flow cytometric assessment of ASGPR expression may be a useful predictor of liver dysfunction following major hepatectomy for HCC in Chinese patients.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):820-4.
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    ABSTRACT: To determine the frequency and factors associated with hypomagnesaemia in hypokalemic type-2 diabetic patients presenting at Civil Hospital, Karachi. A cross-sectional study. Department of Medicine and Diabetic Clinic of Civil Hospital and Dow Medical College, Karachi, from November 2010 to May 2011. A total of 358 adult type-2 diabetics with hypokalemia were selected for this study. With aseptic measures, venous blood was collected for serum magnesium, potassium, HDLc, LDLc Triglyceride (TGs) and glycosylated hemoglobin (HbA1c) from each subject after an overnight fasting and was analyzed on Roche Hitachi 820 Photo Spectrometry. The data was analyzed on SPSS version 17 to determine the factors associated with hypomagnesaemia like duration of diabetes, Body Mass Index (BMI), diabetic nephropathy, HDLc, LDLc Triglyceride (TGs) and glycosylated hemoglobin (HbA1c) level. Mean age of study population was 55.62 ± 9.9 years. Most of them (n=228, 63.7%) were males. Out of the 358 subjects, 198 (55.3%) had hypomagnesaemia. There was significant association between hypomagnesaemia with duration of diabetes, Body Mass Index (BMI), diabetic nephropathy, HDLc, LDLc Triglyceride (TGs) and glycosylated hemoglobin (HbA1c) level. Hypomagnesaemia is very common in type-2 diabetic hypokalemic patients. Therefore, it should be routinely sought by the clinicians. Early recognition and subsequent treatment of hypomagnesaemia may help in better glycemic control, may delay the chronic complications and decrease the mortality in diabetic hypokalemic patients.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):830-5.
  • Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):873-4.
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    ABSTRACT: To compare the postoperative short-term and mid-term complications in patients who underwent CBD exploration and closure by using T-tube or primary closure. Prospective randomized clinical trial. Hepatobiliary Department of First Affiliated Hospital of Xinjiang Medical University, Urumqi, China, from August 2009 to March 2013. A total of 148 consecutive patients with Common Bile Duct Stones (CBDS) and CBD dilation were enrolled in this randomized study to undergo open cholecystectomy with CBD exploration. Pre-operative findings, postoperative short-term complications, postoperative follow-up (mid-term), and hospital stay were recorded and analyzed. A T-tube was inserted in 76 (51.35%) patients and the primary closure was done in 72 (48.64%) patients. There were no differences in the demographic characteristics and clinical presentations between the two groups. Compared with the T-tube group 8.97 ± 1.629 days, the postoperative stay in primary closure 5.34 ± 1.25 days was significantly shorter (p < 0.01). The incidence of overall postoperative short-term complications and mid-term complications were statistically but not significantly lower in the primary closure group (9.7%) than that in T-tube group (17.10%, p=0.189). Complications in the primary closure group were lower than that in T-tube group but there was no significant statistical difference. So during open surgery for CBD stones, primary closure of CBD appeared safe and effective with shorter hospital stays and less complications.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):810-4.
  • Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):877-8.
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    ABSTRACT: To assess the response to Neoadjuvant Chemotherapy (NAC) in Locally Advanced Breast Cancer (LABC) in terms of pathological response, overall survival and feasibility of breast conservation surgery. Case series. King Fahad Medical City (KFMC), Riyadh, from January 2009 to July 2012. All patients of LABC who received NAC and underwent surgery were included. All these patients received the GORG001 regimen (FEC+Docetaxal+Cisplatin+/-Herceptin). After chemotherapy patients were offered surgery either Modified Radical Mastectomy (MRM) or Breast Conservation Surgery (BCS) +Radiotherapy. Patients were then followed to exclude local or distant metastasis. RESULTS were described in percentage. The median age at the time of diagnosis was 46.8 years. While complete response was achieved in 24 (44.4%) patients, 14 (25.9%) of the patients had partial response and 16 (29.6%) progressed clinically. Surgery was performed in these patients after NAC. Forty (74%) patients had MRM, 14 (25.9%) had BCS; all had axillary lymph node dissection. Invasive ductal carcinoma accounted for 92% of cases. Vascular invasion was present in 12 (22%) of the patients. Estrogen / progesterone receptor positivity was 61%. Thirty nine percent of the patients were Her2 positive. On an average, follow-up of 4 - 51 months in the MRM group, one patient had resection margin (deep) positive and was treated with adjuvant therapy. While in the BCS group after 3 - 26 months of follow-up, one patient had resection margin positive (medial margin) and underwent MRM, while no patient had local or distant metastasis in both the groups. NAC caused down staging of disease in LABC making more conservative surgery feasible. BCC should be considered as an option for treatment of LABC, however, longer follow-up is recommended.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):845-8.
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    ABSTRACT: We report experience of managing Choledochal Cyst (CC) in different paediatric ages. Eleven neonates and infants (aged 0-8 months) and 24 paediatric cases (aged 2.5 - 18 years) were managed over 24 years (1988 to 2012). Neonates and infants presented with jaundice, acholic stools and abdominal mass whereas most of the paediatric cases presented with intermittent non-specific abdominal pain. Morphology of CC was mostly cystic in neonates whereas it was fusiform in majority (62%) of paediatric cases. Biliary amylase was high and correlated with the presence of abnormal pancreaticobiliary junction (PBJ) in 20 /24 paediatric patients. Obstruction at the lower end of bile duct, liver fibrosis and cirrhosis were common in neonates. In conclusion, CC in newborns and infants is different and mimic correctable Biliary Atresia (BA). Early excision of CC and biliary reconstruction is promising in neonates, infants and children and it can be performed with minimal morbidity.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):868-70.
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    ABSTRACT: Hemobilia is defined as bleeding into the biliary tree from an abnormal communication between a blood vessel and bile duct. It is an uncommon cause of upper gastrointestinal hemorrhage and iatrogenic most of the times. We report a case of hemobilia secondary to percutaneous liver biopsy presenting with classical Quincke's triad in a young lady which was treated with combined biliary balloon sweep thrombectomy and transarterial embolization for complete resolution of symptoms.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):865-7.
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    ABSTRACT: To determine the clinical significance of silent mating type information regulation 2 homolog 1 (SIRT1) expression in Hepatocellular Carcinoma (HCC) and its association with P53 and Yes-associated protein 2 (YAP2) expression. Observational study. Department of General Surgery, China-Japan Union Hospital of Jilin University, Changchun, China, from January 2000 to January 2010. Tissue microarray technique and immunohistochemistry were conducted to detect the expression of SIRT1, P53 and YAP2 proteins in 300 self-paired HCC samples. Associations with clinicopathologic manifestations were analyzed, overall survival analysis and multivariate analysis were performed. By tissue microarray technique and immunohistochemistry on 300 self-paired HCC samples, it was found that SIRT1, P53 and YAP2 were significantly overexpressed in HCC tumor tissues compared with adjacent non-tumor tissues. SIRT1 immunostaining localized both in the nucleus (145/300, 48.3%) and the cytoplasm (70/300, 23.3%), and the overexpression of nuclear SIRT1 was positively related to the overexpression of P53 and YAP2. Survival analysis showed that nuclear SIRT1, P53 and YAP2 overexpression predicted poor overall survival while cytoplasmic SIRT1 overexpression predicted longer overall survival. Multivariate analysis showed nuclear SIRT1 and P53 overexpression as independent tumor promoters while cytoplasmic SIRT1 overexpression as an independent tumor suppressor. SIRT1 was overexpressed in HCC and the expression was positively related to P53 and YAP2 expression. As the nuclear SIRT1 functions as a tumor promoter and cytoplasmic SIRT1 functions as a tumor suppressor, the role of SIRT1 in HCC should be reconsidered.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):849-54.
  • Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):871-2.
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    ABSTRACT: Cholera is one of the notifiable endemic diseases in Pakistan, but the reporting of cholera cases is still unsatisfactory. Most of the diagnosed cases are never reported to the relevant authorities. In the year 1993 - 2005, the country did not report any single case of cholera to the WHO. The objectives of this review were to understand the epidemiology and to identify the possible determinants of cholera infection in Pakistan. Medscape, Medline, PakMedinet and PubMed, was searched, using key words, epidemiology and determinants of cholera infection in Pakistan during 1995 - 2010. Morbidity and mortality due to cholera infection during 1995 - 2010, without any language restriction. Out of 27 articles published between 1995 - 2010, 17 articles were included in the review. Vibrio cholerae O139 identified as a major cause of infection in older age group, while O1 biotype of cholera as a predominant cause of cholera among young individuals. Mainly reported determinants of cholera in Pakistan include poor sanitation and hygiene practices, increased population density in urban areas, leading to rapid and unplanned urbanization of the major cities and climate change due to increased environmental pollution in Pakistan are plausible factors for endemicity of cholera in Pakistan. Cholera reporting as a notifiable disease to the relevant departments and timely action can prevent the risk of outbreaks. There is a need to identify specific behavioral and environmental determinants responsible for outbreaks and epidemics of cholera in Pakistan which can help to design appropriate preventive and control interventions.
    Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):855-60.
  • Journal of the College of Physicians and Surgeons--Pakistan: JCPSP 11/2014; 24(11):875-6.