Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsOmphalomesenteric Duct Fistula: A Rare Manifestation of Omphalomesenteric Duct Anomalies.
Omphalomesenteric duct (OMD) anomalies occur as a result of resorption failure during gestation. Various forms of OMD anomalies are documented depending upon the degree of resorption (complete or partial) including Meckels diverticulum, fistulas, fibrous bands, and cysts to umbilical polyps. Among these, Meckels diverticulum is the most common of these anomalies, and omphalomesenteric duct fistula (OMF) is the most rare. ⋯ We report a rare case of a 10-day male neonate who presented with umbilical swelling and discharge. This case is presented to highlight the occurrence of this extremely rare phenotype to raise a high index of suspicion and awareness among healthcare providers. Key Words: Omphalomesenteric duct fistula, Umbilical swelling, Sinogram.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsUrinary Tract Infection in a Renal Transplant Patient by Myroides Species: A Case Report from Pakistan.
Myroides species are mostly considered to have low pathogenic potential causing infections in immuno-compromised patients; though, few cases of urinary tract infections (UTIs), bacteremia, pneumonia, endocarditis, ventriculitis, skin, and soft tissue infections have been reported. The two most common species associated with human infections are M. odoratus and M. odoratimimus. Due to the multi-drug resistant nature of this bacteria, prompt identification and antibiotic susceptibility testing in the laboratory are of paramount importance in order to direct the clinician towards an appropriate antibiotic treatment. ⋯ This is the first reported case of a clinically significant infection caused by Myroides species from Pakistan. The patient in this case responded favorably to treatment by oral minocycline and was treated successfully. Key Words: Myroides, Multi-drug resistant, Urinary tract infection, Renal transplant.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsPathological Fracture of Humerus as Initial Presentation of Infiltrative Follicular Subtype of Papillary Thyroid Microcarcinoma.
Papillary thyroid microcarcinomas (PTMCs) are subcentimetre papillary carcinomas with benign behaviour. Infiltrative follicular subtype of PTMC (IFPTMC) is considered an indolent lesion with propensity to nodal metastasis. Here, we report a case of unifocal IFPTMC with no lymphadenopathy, presenting with fracture of humerus due to metastasis. ⋯ Treating PTMC aggressively with total thyroidectomy has, no doubt, led to a worldwide epidemic of thyroid cancers. But are we confident enough to render active surveillance as their only treatment? Research work is still needed to identify the prognostic factors of PTMC that could guide clinicians to choose appropriate treatment. Key Words: Thyroid, Papillary microcarcinoma, Follicular subtype, Bony metastasis.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsHeterotopic Pregnancy: A Case Report of Intrauterine Mole with Tubal Pregnancy.
We report a rare case of intrauterine molar pregnancy along with ectopic tubal pregnancy. A 33-year woman who had never been pregnant had an ultrasound (US) after 70 days of amenorrhea suggesting partial hydatidiform mole, with a history of ovulation promotion and pathologically confirmed complete hydatidiform mole after uterine suction dilation and curettage. ⋯ A hysteroscopy with a laparoscopic exploration of the left adnexal mass and salpingotomy confirmed a diagnosis of intrauterine hydatidiform mole combined with left tubal pregnancy. Key Words: Heterotopic pregnancy, Intrauterine hydatidiform mole, Tubal pregnancy.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsClinicopathological Features of Patients with Anti-NMDA Receptor Encephalitis: Experience from a Tertiary Care Centre in Pakistan.
Anti-N-Methyl-D-Aspartate Receptor (NMDAR) antibody encephalitis is a potentially lethal form of autoimmune encephalitis in which auto-antibody production occurs against the NMDAR, NR1 subunit, causing massive dysregulation of neuro-transmission. This syndrome is often paraneoplastic (ovarian teratomas) having a male-to-female ratio of 1:4 and most often manifests with neuropsychiatric signs and symptoms, including hallucinations, memory loss, and diminished conscious level leading to death. ⋯ All three patients had a prodrome of fever, abnormal psychiatric behaviour, decreased consciousness level, speech dysfunction, and autonomic instability; however, seizures and movement disorders were only present in two patients. Key Words: Anti-NMDAR antibody, Anti-NMDAR encephalitis, Autoimmune encephalitis.