Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsA Suspected Case of COVID-19 with High Altitude-associated Massive Pulmonary Embolism and Right Ventricular Clots.
Pulmonary Embolism (PE) is an elusive entity that has long baffled physicians. At times, it can present as a diagnostic and therapeutic challenge. The aim of this report is to emphasise that high altitude is one of the risk factors for PE. ⋯ A high index of suspicion is required for the diagnosis and management of PE. If standard imaging techniques cannot be used due to clinical constraints, ancillary techniques must be effectively employed during management. Key Words: Pulmonary embolism, Thrombolysis, High altitude, COVID-19.
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J Coll Physicians Surg Pak · Jan 2023
Barcode Medication Administration Technology to Prevent Medication Errors.
Medication errors cause harm to patients at any point along the medication administration process and can be prevented. Barcoding medication administration (BCMA) is effective as a clinical decision support system (CDSS) to avoid errors. ⋯ The objective of this article is to increase awareness regarding BCMA and how it can decrease patient morbidity and mortality, enhance safety, and lower overall hospital-associated costs by preventing medication errors. Key Words: Bar-code medication administration, Medication errors, Adverse drug events, Patient safety.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsMalignant Transformation of Vestibular Schwannoma at First Occurrence without Prior Irradiation.
Intracranial malignant peripheral nerve sheath tumours (MPNST) arising from the vestibulocochlear nerve are quite rare. Due to the increasing use of stereotactic radiosurgery worldwide for benign intracranial lesions, the literature available has primarily focused on the post-radiotherapy malignant transformation of vestibular schwannomas (VSs). To date, very few cases have been reported enlightening the occurrence of MPNST without prior irradiation or a history of neurofibromatosis. ⋯ The diagnosis was low-grade MPNST arising in the background of vs. based on mitosis, loss of H3K27me3, and radiologically infiltrative borders. The main objective of this case report was to emphasise the need for a cautious assessment of VSs with hypercellularity and atypia for mitosis, necrosis and invasion to exclude malignancy. Key Words: Schwannoma, malignant peripheral nerve sheath tumour, neurofibromatosis, vestibular.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsAnaesthetic Management of a Child with Propionic Acidemia.
Propionic acidemia (PA) is an inherited autosomal recessive disorder of metabolism caused by a deficiency of propionyl CoA carboxylase, an enzyme that catalyses the conversion of propionyl CoA (PCA) to methylmalonyl CoA, inside the mitochondria, leading to inadequate metabolism of propionyl CoA causing hyperammonemia and metabolic acidosis. Children with PA require dextrose infusion to avoid protein catabolism. This child presented with severe metabolic decompensation and required urgent venous cutdown as there was a failure in establishing a peripheral intravenous line. Key Words: Propionic acidemia, Propionyl CoA, Emergency, Mitochondrial disorder, Organic acidemias.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsA Rare Chemical, Biological, Radiological, and Nuclear Hazards Event: Asphalt Burns.
Chemical injury in chemical, biological, radiological, and nuclear hazards (CBRN) occurs as a result of exposure to chemical warfare agents or chemical substances after a work accident. Asphalt is a chemical substance and asphalt burns occurring after a work accident are an example of these kinds of burns. The risk of burns due to asphalt material at high temperatures is high for workers engaged in road and roof construction. ⋯ In the present case, asphalt residues were found in various parts of the patients body as a result of isolated high-temperature asphalt exposure. In this case, sunflower oil was used as a solvent after early cooling with water, and the results are presented. Key Words: Work accident, Asphalt burns, Sunflower oil, CBRN hazards.