Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jul 2021
Case ReportsPost-COVID Neuromyelitis Optica Spectrum Disorder.
After novel coronavirus pandemic that emerged from Wuhan, China in December 2019, several cases of inflammatory and immune-mediated disorders have been reported, thought to be triggered by SARS-CoV-2 infection. Neuromyelitis optica spectrum disorder (NMOSD) is one of the autoimmune demyelinating disorders, which is thought to be triggered by viral infection. Herein, we describe a case of NMOSD in a pediatric patient with a previous SARS-CoV-2 infection, acting as a possible triggering factor. Key Words: Neuromyelitis optica spectrum disorder (NMOSD), Aquaporin 4 (AQP-4), Severe acute respiratory syndrome (SARS).
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J Coll Physicians Surg Pak · Jul 2021
BTD Gene Mutations in Biotinidase Deficiency: Genotype-Phenotype Correlation.
To identify the biotinidase (BTD) gene mutations in patients with biotinidase deficiency in our region; and to determine the phenotype-genotype correlations in the presence of clinical findings. ⋯ Common mutations in BTD deficiencies were indentified. Associating them with phenotype-genotype data will assist clinicians in better genetic counselling and management in the future by implementing prevention programmes. Key Words: Biotinidase deficiency, BTD gene, Newborn screening, Inherited metabolic disease, Newborn screening programme.
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J Coll Physicians Surg Pak · Jul 2021
Negative-to-Positive Lymph Node Ratio as an Independent Prognostic Factor for Gastric Adenocarcinoma.
To investigate the association between the ratio of negative/positive lymph nodes (RNP) and other clinic pathological parameters. ⋯ The ratio of negative/positive lymph nodes can be used as an independent prognostic marker in patients with gastric cancer, who undergo curative resection, as an alternative prognostic marker to the pathologic N stage. Key Words: Stomach neoplasms, Lymph node ratio, Prognosis, Gastrectomy, Lymph nodes.
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J Coll Physicians Surg Pak · Jul 2021
Case ReportsThe Strategic Role of Healthcare Professionals in the Battle Against COVID-19: Do We Really Need Help from Community Pharmacists?
Wuhan, the capital of China's Hubei province, was recognised in December 2019 as the centre of an outbreak of an unknown originator of pneumonia. Intense concentrations of illness spread throughout China and, ultimately, globally. ⋯ In a multidisciplinary team, pharmacists play a strategic role as medical healthcare professionals in restricting the dissemination of SARS-CoV-2 and can serve as sentinels in their communities to control and counteract this epidemic domestically. Key Words: SARS-CoV-2, Community pharmacists, Frontline healthcare workers.
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J Coll Physicians Surg Pak · Jul 2021
The Role of FDG PET/CT to Evaluation of Axillary Lymph Nodes after Neoadjuvant Chemotherapy in Breast Cancer.
To determine the diagnostic value of breast and axillary maximum standard uptake (SUVmax) values for predicting ypT0 and ypN0 separately. ⋯ Department of Medical Oncology, Haydarpasa Numune Training and Research Hospital, between May 2017 and September 2020. Methodology: Consecutive patients with operated breast cancer (BC) after neoadjuvant chemotherapy (NAC) were evaluated. SUVmax on FDG-PET/CT after NAC at both primary tumour (postSUVmax-T) and axillary lymph nodes (postSUVmax-N) were assessed to predict the ypT0 and the ypN0, respectively. Results: Clinically meaningful correlation was detected between postSUVmax-N with ypN0 in patients with human epidermal receptor-positive (Her2+) and triple-negative (TN) BC (in Her2+ BC: r=0.596, p <0.001, in TN BC: r=0.782, p = 0.001). The postSUVmax-N predicted ypN0 with 90.5% positive predictive value (PPV) and 85.7% negative predictive value (NPV) in patients with Her2+ and TN BC. The postSUVmax-T predicted ypT0 with 87.5% PPV and 100% NPV in patients with TN BC (AUC: 0.938, P <0.01) Conclusion: According to this study's findings, the FDG-PET/CT may be an alternative to sentinel lymph node biopsy (SNB) to protect patients from axillary lymph node dissection when the expected FNR of the SNB is high in patients with Her+ and TN BC. Key Words: Breast cancer, FDG PET/CT, Neoadjuvant therapy.