Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jul 2022
Case ReportsBorderline-resectable Undifferentiated Carcinoma with Osteoclast-like Giant Cells of the Pancreas: upfront Surgery or Neoadjuvant Chemotherapy?
Undifferentiated carcinoma with osteoclast-like giant cells (UDC-OGC) of the pancreas is an extremely rare entity, thus an obvious discrepancy regarding their treatment approach exists in the current literature. A 52-year female patient with a two-weeks history of jaundice was diagnosed as borderline-resectable pancreatic mass located in the uncinate process of a size of 5×4 cm. ⋯ Considering their aggressive behavior, NACT followed by surgery seems to be a good option in case of borderline-resectable UDC-OGC. Key Words: Neoadjuvant chemotherapy, Pancreatic neoplasms, Undifferentiated carcinoma, giant cells, Pancreaticoduodenectomy.
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J Coll Physicians Surg Pak · Jul 2022
Augmentation Cystoplasty in Adult Patients with Renal Impairment.
Bladder augmentation is beneficial in patients with neurogenic bladder due to spinal cord injury, multiple sclerosis, and tuberculous bladder. This retrospective study was done to determine the outcome of augmentation cystoplasty in adult patients with renal dysfunction. The study was done at the Sindh Institute of Urology and Transplantation (SIUT), Karachi from January 2010 till December 2019. ⋯ Results from this study showed that augmentation cystoplasty is a safe operative procedure even in renal failure patients. It leads to improvement in renal functions in a significant number of patients. Key Words: Adults, Augmentation cystoplasty, Renal failure, Bladder compliance.
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J Coll Physicians Surg Pak · Jul 2022
Observational StudyPrognostic Nutritional Index in Short-term Postoperative Outcomes in Hepaticojejunostomy.
To investigate the utility of prognostic nutritional index (PNI) on short-term complications, biliary fistula, mortality, and morbidity in patients undergoing hepaticojejunostomy (HJ) procedure. ⋯ Prognostic nutritional index, Hepatic duct, Biliary tract, Biliary fistula.
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J Coll Physicians Surg Pak · Jul 2022
Observational StudyAnti-Phospholipase A2 Receptor Antibodies in Biopsy-Proven Idiopathic Membranous Nephropathy: A Report from the Pakistani Population.
This study aimed to determine the percentage of anti-phospholipase A2 receptor (PLA2R) autoantibody positivity in a cross-section of 74 Pakistani patients with biopsy-proven idiopathic membranous nephropathy. It was an observational study conducted from December 2018 to June 2019. Seventy-four (n=74) consecutive biopsy-proven cases of membranous nephropathy, aged between 12-60 years, were included. ⋯ Anti-PLA2R antibodies were detected in approximately half of the diagnosed idiopathic membranous nephropathy cases. However, this percentage was much lower than the studies conducted on other populations around the globe, indicating a possible pathogenic role of other antigens in our population. Key Words: Membranous nephropathy, Phospholipase A2 receptors, Renal biopsy.
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J Coll Physicians Surg Pak · Jul 2022
Case ReportsA Case of Euglycemic Diabetic Ketoacidosis due to Empagliflozin Use in a Patient with Type 1 Diabetes Mellitus.
Euglycemic diabetic ketoacidosis is characterised by serum blood glucose <250 mg/dl, arterial blood pH <7.35, and the presence of ketones in urine or blood. Here, we present a 36-year female with type-1 diabetes mellitus, a case of euglycemic diabetic ketoacidosis, who was admitted to the emergency unit with nausea, vomiting, and confusion after using empagliflozin, which was added to her treatment one month ago. She was followed up in the intensive care unit for four days. ⋯ Euglycemic diabetic ketoacidosis should be kept in mind as a differential diagnosis in patients with type-1 diabetes and type-2 diabetes presenting with acidosis. Attention should be paid to the patients' medications and whether there are SGLT-2 inhibitors among these drugs. Key Words: Diabetes mellitus, Sodium-glucose co-transporter-2 inhibitors, Euglycemic diabetic ketoacidosis, Empagliflozin.