Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Sep 2020
Case ReportsKikuchi-Fujimoto Diseasae: An Important Differential of Tuberculous Lymphadenitis.
Kikuchi-Fujimoto disease, also called necrotising histiocytic lymphadenitis, is a rare disease of usually benign outcome. A case of a 21-year female is reported here. She presented with high grade fever and cervical lymphadenopathy. ⋯ Of significant note, two of patient's siblings were treated for pulmonary TB, because of which she had strong history of direct TB contact. Although a few cases of Kikuchi-Fujimoto disease have been reported in Pakistan, this is first case being reported in setting of very strong positive history of TB contact. Key Words: Lymphadenitis, Tuberculosis, Kikuchi-Fujimoto disease.
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J Coll Physicians Surg Pak · Sep 2020
Observational StudySystemic Immune-inflammation Index is the Best Prognostic Factor in Patients with Advanced Stage Adenocarcinoma of the Lung Treated with Pemetrexed.
To evaluate the prognostic role of systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients who received platin-pemetrexed combination therapy and/or maintenance pemetrexed therapy. ⋯ In the univariate analyses, NLR-low group and SII-low group had significantly longer PFS compared to NLR-high and SII-high groups (10 months vs. 8 months, p=0.018, and 13 months vs. 8 months, p<0.001, respectively). The significant differences were seen between SII-low and SII-high groups for OS (24 months vs. 13 months, p=0.001). In multivariate analyses, response to treatment and low-SII were independent prognostic factors for PFS (HR: 0.25, p<0.001, and HR: 0.47, p=0.002, respectively) and OS (HR: 2.09, p=0.001, and HR: 2.05, p=0.001, respectively). Conclusion: SII is the most powerful of the three studied inflammatory indices, which could independently predict overall and progression-free survival. Key Words: Systemic immune-inflammation index, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Adenocarcinoma, Lung cancer, Pemetrexed.
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J Coll Physicians Surg Pak · Sep 2020
Case ReportsEarly Pneumopericardium after Endoscopic Thoracic Sympathectomy.
Pneumopericardium is a condition characterised by the presence of air within the pericardium. We hereby present a case of a rare potentially life-threatening complication, which is, to our knowledge, the first report of the pneumopericardium after single port endoscopic thoracic sympathectomy (SPETS). A 25-year male patient with a history of bilateral palmar hyperhidrosis underwent SPETS. ⋯ Based on clinical experience, routine postoperative clinical follow-up protocols should be established and applied for each patient following SPETS. Key Words: Palmar hyperhidrosis, Endoscopic thoracic sympathectomy, Pneumopericardium.
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J Coll Physicians Surg Pak · Sep 2020
Efficacy and Safety of Early Tracheotomy in Acute Cervical Spinal Cord Injury.
To evaluate the clinical efficacy and safety of early tracheotomy versus delayed tracheotomy for patients with cervical spinal cord injury. ⋯ Compared with delayed tracheotomy, early tracheotomy can significantly reduce the duration of mechanical ventilation, duration of indwelling tracheal tube, and hospital stay. Early tracheotomy did not increase the risk of infection of the cervical spine internal fixation. Therefore, early tracheotomy was beneficial and safe for patients. Key Words: Spinal cord injuries, Tracheotomy, Complications.
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J Coll Physicians Surg Pak · Sep 2020
Randomized Controlled TrialNeurectomy versus Nerve Sparing in Open Inguinal Hernia Repair: A Randomised Controlled Trial.
To determine the effect of neurectomy in reducing the frequency of chronic inguinodynia after mesh hernioplasty in open inguinal hernia repair. ⋯ Excision of ilioinguinal and iliohypogastric nerve in inguinal mesh hernioplasty reduces the frequency of chronic inguinodynia. Ilioinguinal neurectomy may be practised routinely in patients undergoing Lichtenstein mesh hernioplasty. Key Words: Inguinal neurectomy, Inguinal hernia, Chronic inguinodynia, Lichtenstein mesh hernioplasty.