Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jun 2020
Association of Programmed Death Ligand-1 Overexpression with the Grade and Stage of Oral Squamous Cell Carcinoma.
ABSTARCT Programmed Death Ligand-1(PD-L) expression can be used to predict targeted therapy against PD-L1/PD-1 pathway in oral squamous cell carcinoma (OSCC). Forty-nine patients were included in the study. Out of the total, 42 well differentiated tumor 3 (7.1%) exhibited strong PD-L1 membranous and cytoplasmic staining, 14 (33.3%) weak staining, and 25 (29.5%) negative staining. ⋯ Stage II (n = 8) tumors had strong PD-L1 expression in 1 (12.5%), weak in 3 (37.5%), and negative in 4 (50%) cases. Stage III had negative in 2/3 (66.7%), weak in 1/3 (33.3%) cases, (p = 0.929). Key Word: Grade, PD-L1, Stage, Squamous cell carcinoma, Oral cracinoma.
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J Coll Physicians Surg Pak · Jun 2020
ROC Curve in Evaluation of Diagnostic Value of Serum 25-hydroxyvitamin-D for PCOS with Depression.
The objective of this study was to apply receiver operating characteristic (ROC) curve to evaluate diagnostic value of serum 25-hydroxyvitamin-D [25-(OH)D] for polycystic ovarian syndrome (PCOS) combined with depression. Serum 25-(OH)D level was determined in 106 PCOS patients. Beck depression scale (BDI) and ROC curve were used to assess the objective. ⋯ Clinical point value of diagnosis of serum 25-(OH)D was 10.89 μg/L. Sensitivity was 75% and specificity was 78.8%. Key Words: Serum, 25-hydroxyvitamin-D [25-(OH)D], Polycystic ovarian syndrome (PCOS) , Depression, Receiver operating characteristic (ROC) curve.
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J Coll Physicians Surg Pak · Jun 2020
Case ReportsMechanical Jaundice and Bile Duct Stricture Caused by the Migration of Endoclip and Silk Suture Material into the Common Bile Duct.
It is quite rare the migration of metal clips and silk suture materials into the common bile duct (CBD) that were used for the closure of cystic duct in conventional or laparoscopic cholecystectomy. The most common cause of postoperative jaundice is unrecognised or overlooked stones in the bile ducts during operation. The authors present four patients who developed jaundice and in one case biliary tract stricture, caused by the migration of metal clip and silk suture material into CBD following conventional and laparoscopic cholecystectomy. The migration of endoclip and suture material in to CBD is very rare and it should be kept in mind in post-cholecystectomy jaundice. Key Words: Cholecystectomy, Endoclip migration, Mechanical jaundice, Endoscopic retrograde cholangiopancreatography.
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J Coll Physicians Surg Pak · Jun 2020
Case ReportsLate Diagnosis of Paracetamol Poisoning is Always Lethal in Young Adult.
Acetaminophen has a remarkable safety profile when prescribed in proper therapeutic doses, but hepatotoxicity can occur when misused or after an overdose. The principal toxic metabolite of acetaminophen is N-acetyl-p-benzoquinone imine (NAPQI). Toxicity should be considered in all suspicious cases because of the ubiquitous and initially asymptomatic nature of acetaminophen intoxication. ⋯ Raised liver function tests and elevated prothrombin time were the first indication to this condition, which were proven by detection of acetaminophen in blood and urine by liquid chromatography-mass spectrometry. Further supportive evidence of hepatic necrosis was provided by an ultrasound abdomen, giving the final diagnosis of acetaminophen poisoning causing drug-induced liver injury. Key Words: Acetaminophen poisoning, Drug-induced liver injury, Fulminant hepatic failure, N-acetylcysteine, N-acetyl-p-benzoquinone imine (NAPQI).
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J Coll Physicians Surg Pak · Jun 2020
Case ReportsHarlequin Fetus in a Twin Pregnancy: An Extremely Rare Presentation.
Harlequin ichthyosis (HI) is a rare fatal type of congenital ichthyosis with autosomal recessive inheritance pattern. We report an uncommon presentation of a case of HI in a neonate, who was the second outcome of the dizygotic twin pregnancy of a Pakistani female. ⋯ Although very few cases of HI from Pakistan have been reported in the past; but this case being one of the outcomes of twin pregnancy is unique in its presentation; and to the best of authors' knowledge, has not been reported earlier. Key Words: Harlequin ichthyosis, Autosomal recessive, Congenital ichthyosis, Twin pregnancy.