Objective: The goal of this research was to use optical coherence tomography to assess the prevalence of diabetic macular edoema and to determine the impact of systemic results and risk factors on the progression of DME. Material and Methods: This cross-sectional research was carried out at the Department of Ophthalmology, Chandka Medical College & Shaheed Mohtarma Benazir Bhutto Medical University Larkana. Patients were asked to fill out questionnaires about their health and lifestyle habits like smoking and alcohol consumption as well as their hemoglobin A1C and lipid profiles, as well as the duration of their diabetes, and the type of diabetes they had. There was an investigation into the link between systemic findings and DME Results: A total of 150 cases met the study's eligibility requirements. Males comprised 84 (56%) of the 150 participants, while females comprised 66 (44%). Sixty-five patients (43.33%) tested positive for DME, while 85 patients (56.66%) tested positive for DR. DME participants had HbA1c levels of 9.39 ± 1.67percent, whereas participants without DME had levels of 7.02 ± 3.23 percent and p=0.326; but no connection was found between the two measurements. There was a statistically significant difference between the mean serum creatine concentrations in cases with and without DME (p=0.011). For DME, a statistically significant difference (P-value = 0.001) was found between normal-albuminuric, microalbuminuric, and macroalbuminuric patients. Using the DME frequency in phakic and pseudophakic eyes as a guide, figure 2 below illustrates the results. Conclusions: Diabetic macular edema was seen in 43.33% of cases in the current study. An OCT-based study revealed that DME is common in Larkana Sindh. Regulating DME risk factors can help prevent or limit the development of DME, and treatment response may be improved. Keywords: Systemic risk factors, Diabetic macular edema, Optical coherence tomography,
Objective: To determine the complications, outcomes associated with temporary ileostomy and to study the complications related to its closure. Material & Methods: This study was conducted on 60 patients for two years from 1 January 2020 to 31 December 2020 at the Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences Gambat Khairpur Mirs, Sindh Pakistan. The researchers looked at ileal perforations larger than one-third of the circumference, gangrene, severe adhesions, and ancient perforations with peritoneal contamination. Clinical, intraoperative, biochemical and stomal, and peristomal problems and tissue histology were evaluated in the research Results: A total of 60 patients were selected, 42 (70%) patients exhibited peritoneal contamination with pus, faecal matter, or blood in cases of trauma or gangrenous gut, 38 (63.33%) Patients found with ileal perforation. We found that 15(62.5%) of patients had skin excoriation with peritoneal contamination (70%, n=42) which shows an insignificant difference (P-value=0.249), four (16.66%) patients showed Mucocutaneous separation insignificantly (p-value 0.671) who reached after 48 hours at the hospital. Twenty (83.33%) of enteric perforation were significantly seen with Paralytic ileus (p-value=0.006). Nine (37.5%) cases with loop ileostomy revealed Ileostomy diarrhea which showed a significant difference (p-value = 0.041). In 8 (12.5%) of patients had significant Incisional hernia who arrived at the hospital after 72 hours, tubercular perforation was significantly seen in 12 (50%) cases, an end ileostomy was observed in 25 (41.66%) patients (p-value=0.024, p-value=0.024, p-value=≤ 0.001). Conclusions: Loop ileostomy is still a life-saving treatment, despite the inconvenience. An easy-to-operate stoma device can help patients to avoid more serious complications, and the appropriate placement of their stomas cannot be overstated. Keywords: Complications, Ileostomy, Temporary
e15514 Background: Colorectal cancer (CRC) is a heterogeneous disease, however there is limited information available regarding molecular classification and correlation with long term clinical outcome. Methods: Over the period of 11 years (2008 to 2018) totals 435 patients of colorectal cancer were reported and their tumour blocks and complete set of clinical information was available for 201 patients. Immunohistochemistry was done for ER, PR, HER 2-neu, Ki-67, Bcl-2, E-Cadherin, P53, CEA, EGFR, and VEGF. PDL1, CDX-2 and CK 20. The biological pattern characterized by partitioned clustering method as described using R software. Survival analysis was done by using Kaplan Meier method. Results: There were 201 patients including 54.7% male and females were 45.3 %. Median survival was 28 months. Cluster analysis showed four novel clusters (Table), with major difference based on Ki67, CDX2 and p53. These classes showed difference in median survival, where common class 1 showed higher survival while common cluster 4 showed poor survival. Conclusions: There are at least four distinct molecular classes of colorectal cancer which can be potentially utilized in clinical practice. Pattern of Novel molecular classification of colorectal cancer and correlation with long term survival.[Table: see text]
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