Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Nov 2021
Case ReportsA Case of Foveoschisis Associated with Ornithine Aminotransferase Deficiency and Gyrate Atrophy.
Gyrate atrophy is a metabolic disorder characterised by typical progressive circular chorioretinal atrophy, myopia and early developmental cataract. The disease is caused by deficiency of ornithine aminotransferase (OAT) enzyme. Although OAT is expressed in most tissues of the body, but the main target of the disease appears to be the retina. ⋯ Optic coherence tomography (OCT) scans showed foveoschisis bilaterally. In summary, gyrate atrophy may present as macular involvement in the form of foveoschisis and may lead to impaired central vision. Key Words: Foveoschisis, Gyrate atrophy, Ornithine aminotransferase.
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J Coll Physicians Surg Pak · Nov 2021
The Influence of OPRM1 A118G Polymorphism on the Dosage of Morphine in Patients with Advanced Liver Cancer.
This study was conducted to investigate the influence of μ-opioid receptor gene (OPRM1) A118G polymorphism on dosage of morphine in advanced liver cancer patients. Seventy patients with advanced liver cancer at Changyi People's Hospital, Shandong Province, China, were included from February 2019 to December 2020. The dosage of morphine in patients with OPRM1 A118G different genotypes was compared. ⋯ In conclusion, OPRM1 A118G genotype may affect the dosage of morphine in advanced liver cancer patients. More dosages of morphine are needed for pain control in patients with G allele. Key Words: μ-opioid receptor gene (OPRM1), Gene polymorphism, Liver cancer, Morphine.
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J Coll Physicians Surg Pak · Nov 2021
Case ReportsUse of Eculizumab in Thrombotic Microangiopathy Associated with Hematopoietic Stem Cell Transplantation.
Thrombotic microangiopathy (TMA) associated with hematopoietic stem cell transplantation, remains a difficult complication due to its high mortality rate, lack of standardised diagnostic criteria, and limited treatment options. Although the etiology of the disease is not clear, medications, radiotherapy, graft-versus-host disease (GVHD), angioinvasive fungal, viral infections and complement activation have been implicated. Agents such as therapeutic plasma exchange (TPE), steroids, rituximab, defibrotide, eculizumab are used in its treatment. ⋯ As there is no standard dose for eculizumab in the treatment of TA-TMA, doses used in atypical hemolytic uremic syndrome (aHUS) were administered. In this paper, we present a case that was unresponsive to TPE and steroids, but which was successfully treated with eculizumab. Key Words: Acute myeloid leukemia, Stem cell transplantation, Thrombotic microangiopathy, Apheresis, Eculizumab.
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J Coll Physicians Surg Pak · Nov 2021
Case ReportsA Rare Case of Posterior Interosseous Nerve Palsy Post-venepuncture.
Wrist drop post-venepuncture is uncommon. There has been reported cases of direct injury to the radial nerve during venepuncture but to our knowledge, there has never been a case of posterior interosseous nerve (PIN) injury. A 34-year female, right hand dominant homemaker, with a newly diagnosed diabetes mellitus, was admitted for diabetic ketoacidosis. ⋯ Despite the transient blood taking session, patient developed neuropraxia, which only resolved after four months. We wish to report this case of unusual presentation of a PIN palsy post- routine venepuncture, which can result in high morbidity to a patient. Key Words: Posterior interosseous nerve syndrome, venepuncture, neuropraxia, wrist drop.