METHODS: We performed a prospective, cross-sectional study on infants with cholestatic jaundice (June 2021-December 2022). Modified SBASS scoring was applied and compared to the eventual diagnosis (as per intraoperative cholangiogram (IOC) and liver histopathology). The score (0-6), consists of gall bladder length 0.7(+ 2), gamma-glutamyl transferase (GGT) ≥ 200 U/L (+ 2).
RESULTS: 73 were included: Fifty-two (71%) had BA. In the non-BA group, 6 (28%) had percutaneous cholangiography (PTC) while 15 (72%) had intraoperative cholangiogram (IOC). At a cut-off of 3, the modified SBASS showed sensitivity of 96.2%, specificity of 61.9% and overall accuracy of 86.3% in diagnosing BA. Area under receiver operating characteristic curve was 0.901. GGT had the highest sensitivity (94.2%), while triangular cord sign showed the highest specificity at 95.2%.
CONCLUSION: The SBASS provides a bedside, non-invasive scoring system for exclusion of BA in infantile cholestatic jaundice and reduces the likelihood of negative surgical explorations.
OBJECTIVES: This study aimed to examine clinical pharmacist interventions and identify opioid medication-related issues in patients with cancer.
METHOD: We conducted a retrospective observational study at Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan, conducting a chart review from 1st July 2021 to 31st December 2021.
RESULTS: Out of 10,534 opioid medication orders, we documented a total of 974 interventions based on our inclusion criteria. Tramadol and morphine accounted for most of these interventions, comprising 49.27% (n = 475) and 40.04% (n = 386), respectively. Regarding clinical significance, 41.70% (n = 406) were deemed significant, while 37.36% (n = 365) were somewhat significant. The majority of interventions, i.e., 54.05% (n = 521), primarily aimed at optimizing patient outcomes, followed by a secondary aim of improvements in communication, i.e., 25.52% (n = 246).
CONCLUSION: This study establishes the evaluation of clinical pharmacist interventions on opioid medication use in patients with cancer, an issue particularly in oncology settings in Pakistan. The findings emphasize the crucial role of clinical pharmacists in addressing issues related to opioid issue medications, thus improving patient safety and optimizing opioid use for patient well-being.
OBJECTIVE: The objective was to review the evidence on the effect of core exercises on clinical and functional outcomes after TKA in individuals with knee osteoarthritis (OA).
METHODS: PubMed, Scopus, CINAHL, Web of Science, the Cochrane Library, and ProQuest databases were explored with appropriate keywords for studies published on the effect of core exercises on TKA from inception to 1 April 2024. Two authors independently screened the titles and abstracts and full-texts, and a third author solved the discrepancies. Risk of bias assessment was done with the Joanna Briggs Critical Appraisal tool. The final articles were systematically summarised.
RESULTS: A total of 1485 records were retrieved. Sixty-four articles were included for screening full-texts, and four articles were ultimately included. Core exercises were administered for three to 6 weeks. The administration of core exercises along with the standard knee rehabilitation programme significantly improved balance, mobility, knee function, transverse abdominis muscle thickness, transversus abdominis contraction, and quality of life after TKA (p