Background: The pediatric risk of mortality (PRISM) score predicts mortality in the pediatric intensive care unit (PICU). This study aimed to evaluate the application of PRISM score as a predictor of mortality in intensive care units of a tertiary hospital.
Methodology: A descriptive cross-sectional study of one year was conducted within the Department of Pediatrics at Ziauddin University and Hospital, located in Karachi, Pakistan. The total number of 263 admitted neonates and children up to the age of 12 years were included. Patients more than 12 years of age admitted in wards and plane for any surgery were excluded from the study; the PRISM score tool was used to collect the data of the neonates and children.
Results: The mean PRISM score was high among non-survivors (15.3 ± 7.2) as compared to survivors (12.7 ± 9.2) (p=0.023). The predictability of the PRISM score regarding pediatric mortality was shown by the area under the curve (AUC) i.e., 0.636.
Conclusion: The PRISM score found a significant difference between survival and death groups. Therefore the implication of the PRISM score can be needed in PICU to reduce the mortality rate.
Background: Percutaneous nephrolithotomy (PCNL) is the treatment of choice for large or complex renal stones. The upper pole (supra-costal access) is associated with pulmonary and cardiac complications post-operatively, owing to its proximity to the diaphragm. The prone position also causes restricted chest expansion and decreased pulmonary compliance. In this study, we aim to evaluate pulmonary complications after percutaneous nephrolithotomy by reducing the tidal volume intra-operatively and to assess the appropriate tidal volume for patients undergoing PCNL.
Methodology: A retrospective chart review was performed over a period of one year (2019-2020). All patients who underwent PCNL and fulfilled the inclusion criteria were included in the study. They were divided into two groups: low tidal volume (Cases), and normal tidal volume (Controls). The records were evaluated for any pulmonary complications post-operatively, and this was compared between the two groups.
Results: A total of 114 patients were included in the study. When patients with low tidal volume were compared to patients with normal tidal volume, no significant difference in pulmonary complications was observed (p-value < 0.05).
Conclusion: There was no significant difference between the two groups, in terms of post-PCNL pulmonary complications, with respect to the tidal volume. Further multicenter studies can better elucidate these findings.
Background: Benign Prostatic Hyperplasia (BPH) is the most common urological cause of urinary obstruction, affecting men above 50 years of age. Medical therapy used for managing BPH includes various medical regimes, including 5-alpha reductase inhibitors (5ARI), namely Dutasteride and more. The study aimed to evaluate the efficacy of four weeks' prior treatment with dutasteride on per-operative blood loss in patients of BPH undergoing transurethral resection of the prostate.
Methodology: A prospective observational study was conducted from January to December 2019 at the Kidney Centre, Karachi, Pakistan. A total of 64 patients were included and divided into two groups. Group A patients were those who had been taking dutasteride (0.5 mg/day) for four weeks or more before surgery, and group B patients were not taking dutasteride drug before surgery. All patients underwent standard TURP, and the intra-operative blood loss was calculated. The collected data was analyzed using SPSS version 22.0.
Results: In our study, there was a significantly less hemoglobin drop (1.2 gm vs. 2.2 gm) during prostate surgery in patients using dutasteride than those who were not using dutasteride.
Conclusion: This study has revealed that the use of dutasteride four weeks before surgery significantly reduces intra-operative bleeding.
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