Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Mar 2022
Case ReportsFollicular Variant of Papillary Thyroid Carcinoma Presenting with Thoracic Vertebral Metastasis: A Rare Phenomenon.
Follicular variant of papillary thyroid carcinoma (FV-PTC) often follows nodal spread; and hematogenous spread is rare. A 77-year male presented to the Neurosurgery Outpatient Clinic with complaints and examination findings of spinal cord compression (SCC) by a mass at the 11th thoracic vertebra (T11). Subtotal mass excision, thoracic corpectomy with cage reconstruction, laminectomy, and posterior spinal stabilisation were performed. ⋯ Even four years after the total thyroidectomy, the neurological status of the patient was still stable and neither tumoral recurrence nor a new metastasis was detected. In the literature, the number of cases with FV-PTC presenting with SCC due to spinal metastasis is limited. Key Words: Thoracic vertebrae, Metastasis, Papillary thyroid carcinoma, Spinal cord compression.
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J Coll Physicians Surg Pak · Mar 2022
Meta AnalysisIntravenous Alteplase Treatment of Acute Ischemic Stroke Patients Exhibiting Mild Neurological Deficits.
Alteplase is increasingly used for treating ischemic stroke cases with low NIHSS scores, but the guidelines and evidence regarding outcomes are lacking. So, the authors conducted an updated meta-analysis to better understand the effects of alteplase for the treatment of acute mild ischemic stroke. PubMed, Cochrane, EMBASE were systematically explored for all relevant investigations published as in September 2021. ⋯ Subgroup analysis showed that the function outcomes was the best within 3-4.5 hours; and the risk and mortality of sICH were the lowest within 3-4.5 hours. Intravenous rt-PA administration is associated with improved functional outcomes at three months after the stroke in mild ischemic stroke patients. Key Words: Acute ischemic stroke, Mild, Alteplase, Meta-analysis.
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J Coll Physicians Surg Pak · Mar 2022
Randomized Controlled TrialSurvival Analysis of Patients with Thoracic Duct Ligation during Thoracoscopic Esophagectomy.
To determinate the effect of thoracic duct ligation during thoracoscopic esophagectomy on esophageal cancer patients survival. ⋯ Thoracic duct ligation during thoracoscopic esophagectomy can affect DFS in patients with pT1b-3N0M0 esophageal squamous cell carcinoma, and the thoracic duct ligation, depth of invasion, degree of differentiation and presence of tumor thrombus are independent factors. Meanwhile, the depth of invasion, presence of tumor thrombus and age were independent factors affecting OS. Key Words: Esophageal cancer, VATS, Esophagectomy, Thoracic duct ligation, DFS, OS.
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J Coll Physicians Surg Pak · Mar 2022
Retroperitoneal Ectopic Pregnancy Presenting as a Massive Retroperitoneal Hematoma.
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J Coll Physicians Surg Pak · Mar 2022
Outcome of Post-intubation Tracheal Stenosis (PITS) with Primary Resection and Anastomosis.
To ascertain the outcome of primary resection anastomosis in patients of post-intubation tracheal stenosis (PITS) and the associated morbidity. ⋯ Post-intubation tracheal stenosis (PITS) is curable disease. Primary resection and anastomosis remain the gold standard with acceptable morbidity and mortality. Key Words: Tracheal stenosis, Intubation, Resection, Primary anastomosis.