Biological and Clinical Sciences Research Journal

Spectrum of Neurological Disorders Undergoing Plasmapheresis in a Tertiary Care Hospital

2025-03-22T10:25:25+00:00

Plasmapheresis is a therapeutic modality widely used in various immune-mediated neurological disorders. Understanding the clinical characteristics, disease spectrum, and treatment outcomes in patients undergoing plasmapheresis can help optimize its use in neurology. Objective: To analyze the demographic characteristics, clinical profile, comorbid conditions, laboratory parameters, and outcomes of patients with neurological disorders treated with plasmapheresis at a tertiary care hospital. Methods: A cross-sectional study was conducted in Ward 28, Department of Neurology, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from November 15, 2024, to February 15, 2025, after obtaining ethical approval. A total of 145 patients aged 15–70 years, of either gender, presenting with suspected neurological diseases and undergoing plasmapheresis, were enrolled using non-probability consecutive sampling. Clinical presentations, diagnoses, and outcomes were recorded and analyzed. Results: The mean age of patients was 40.1 ± 15.6 years, with an average height of 1.7 ± 0.14 meters and weight of 74.11 ± 14.1 kg. Weakness and pain were the most common presenting symptoms, each reported in 72 patients (49.65%). The most frequently diagnosed condition was Guillain-Barré Syndrome (GBS) in 77 patients (53.10%), followed by Myasthenia Gravis (MG) in 36 (24.83%), Neuromyelitis Optica Spectrum Disorder (NMOSD) in 22 (15.17%), and Myelin Oligodendrocyte Glycoprotein Antibody Disease (MOGAD) in 10 patients (6.90%). Conclusion: The findings highlight Guillain-Barré Syndrome as the most common neurological condition requiring plasmapheresis. Variations in demographic and clinical features emphasize the need for localized data to inform diagnostic accuracy and therapeutic strategies in immune-mediated neurological disorders.

Diagnostic Accuracy of MRCP in the Evaluation of Obstructive Jaundice

2025-03-21T16:04:18+00:00

Obstructive jaundice is a significant clinical condition that requires timely and accurate diagnosis to guide appropriate management. Endoscopic Retrograde Cholangiopancreatography (ERCP) is considered the gold standard but is invasive and associated with potential complications. Magnetic Resonance Cholangiopancreatography (MRCP) offers a non-invasive alternative, and its diagnostic accuracy warrants evaluation. Objective: To determine the diagnostic accuracy of MRCP in diagnosing obstructive jaundice using ERCP as the reference standard. Methods: This prospective observational study was conducted at the Jinnah Postgraduate Medical Centre (JPMC), Karachi, from September 1, 2024, to February 28, 2025, after obtaining ethical approval. A total of 109 patients aged 18 years or older, of either gender, presenting with clinical features of obstructive jaundice, including jaundice, pruritus, dark-colored urine, and pale stools, were enrolled through non-probability sampling. Patients with contraindications to MRCP or a history of prior biliary surgery were excluded. MRCP findings were compared with ERCP to evaluate diagnostic accuracy. Receiver Operating Characteristic (ROC) curve analysis was performed using SPSS Version 25. Results: MRCP demonstrated a sensitivity of 86.4% and specificity of 88% in diagnosing obstructive jaundice when compared with ERCP. ROC curve analysis revealed an area under the curve (AUC) of 0.864, with a statistically significant p-value (<0.001), indicating strong diagnostic performance. Conclusion: MRCP demonstrates high diagnostic accuracy in detecting obstructive jaundice and can serve as a reliable, non-invasive alternative to ERCP, particularly in the initial diagnostic evaluation or in patients where ERCP is contraindicated.

Diagnostic Accuracy of Contrast-Enhanced MRI in Diagnosing and Staging Urinary Bladder Carcinoma, Taking Histopathology as Gold Standard

2025-03-22T10:00:21+00:00

Urinary bladder carcinoma is a common malignancy with significant morbidity and mortality. Accurate diagnosis and staging are essential for guiding treatment decisions. Contrast-enhanced magnetic resonance imaging (CE-MRI) provides a non-invasive approach for evaluating bladder tumours; however, its diagnostic accuracy compared to histopathology, the gold standard, requires validation. Objective: To evaluate the sensitivity, specificity, and diagnostic accuracy of contrast-enhanced MRI in diagnosing and staging urinary bladder carcinoma in comparison to histopathological findings. Methods: This prospective observational study was conducted at the Jinnah Postgraduate Medical Centre (JPMC), Karachi, from September 1, 2024, to February 28, 2025, following ethical approval. A total of 25 patients aged ≥18 years, of either gender, with clinical suspicion of urinary bladder carcinoma, were enrolled using non-probability consecutive sampling. Patients with contraindications to MRI or a history of contrast allergy were excluded. All patients underwent CE-MRI followed by cystoscopic biopsy for histopathological confirmation. The sensitivity, specificity, and diagnostic accuracy of CE-MRI were calculated by comparing MRI findings with histopathological results. Results: CE-MRI demonstrated a sensitivity of 53.85%, specificity of 75%, and an overall diagnostic accuracy of 64% in detecting and staging urinary bladder carcinoma. Conclusion: Contrast-enhanced MRI shows moderate diagnostic accuracy in the detection and staging of urinary bladder carcinoma. While it provides valuable non-invasive insights, its limited sensitivity underscores the continued importance of histopathology for definitive diagnosis.