Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsHashimoto's Encephalopathy Presenting with Status Epilepticus and Mental Disorder as the Main Manifestations.
Hashimotos encephalopathy (HE) is an uncommon disease. It is easily misdiagnosed as many clinicians have an insufficient understanding of it. The clinical presentation, auxiliary examination, diagnosis, and treatment of a patient with HE were retrospectively analysed, and the relevant literature was reviewed and summarised. ⋯ Most patients have a good prognosis but early investigation of thyroid function and antibodies is imperative for an early and accurate diagnosis. An early treatment can greatly improve patient prognosis. Key Words: Status epilepticus, Hashimotos encephalopathy, Autoimmune disease, Mental disorder.
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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
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 ReportsAn Uncommon Gastrointestinal Manifestation of Systemic Lupus Erythematosus: Lupus Enteritis.
Systemic Lupus Erythematosus (SLE) is a chronic inflammatory disorder with heterogeneous presentation and clinical course. We present a case of a young female with an atypical presentation of SLE. A young woman with no known prior comorbidities presented with a history of chronic diarrhoea, vomiting, and weight loss, followed by generalized weakness. ⋯ She was given pulse therapy to which she responded very well. The case describes the importance of high clinical suspicion and timely intervention as well as adds to the evidence on a rare clinical entity of lupus enteritis. Key Words: Systemic lupus erythematosus, Lupus enteritis, Autoimmune disorder, Chronic diarrhoea.
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J Coll Physicians Surg Pak · Jan 2023
Case ReportsType B Aortic Dissection Converted into Type A Aortic Dissection.
A young patient presented to the emergency room (ER) with Type B aortic dissection and ascending aorta aneurysm. He was planned for medical optimization, close surveillance, echocardiography, and ascending aorta replacement on an urgent basis. His surveillance echocardiogram 2 days later revealed that Type B aortic dissection has converted into Type A aortic dissection. ⋯ A 25-sized SJ aortic valve- conduit was used for root replacement. The patient did very well and got discharged from the hospital on the sixth postoperative day. Key Words: Type A aortic dissection, Aortic root and ascending aorta aneurysm, Type B aortic dissection.