Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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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.
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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 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 ReportsChallenging Pain Management in a Patient with Trigeminal Neuralgia Secondary to Multiple Sclerosis.
Patients suffering from multiple sclerosis (MS) often develop neuropathic pain. Trigeminal neuralgia (TN) is the most common type in these patients. The pain is characterised by recurrent, unilateral, brief, electric shock-like episodes, abrupt in onset and termination, and limited to the distribution of one or more divisions of the trigeminal nerve, which is difficult to treat when compared to classical TN. ⋯ However, due to severe side effects she had to quit its use. The patient was then successfully treated with an intravenous infusion of lidocaine and remained pain-free without any other pain medications. Key Words: Trigeminal neuralgia, Multiple sclerosis, Lidocaine.
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J Coll Physicians Surg Pak · Jan 2023
Meta AnalysisCombination Treatment with Iodine 125 Seeds Implant and Systemic Therapy vs. Systemic Therapy Alone for Non-small Cell Lung Cancer: A Systematic Review and Meta-analysis.
Combination treatment with iodine 125 seeds implant and systemic therapy in patients with non-small-cell lung cancer (NSCLC) is a promising treatment practice. The present study aimed to assess the relative efficacy and toxicity of combination treatment versus systemic therapy alone in patients with NSCLC. Databases including PubMed, EBSCO, Web of Science, EMBASE, Cochrane Library, CNKI, and WanFang were searched for relevant randomised controlled trials (RCTs). ⋯ In terms of adverse events, the combination therapy significantly increased the incidence of pneumothorax (RR = 4.91, 95% CI: 2.63 - 9.17, p <0.001); however, no significant differences were found in the incidence of myelosuppression and gastrointestinal symptoms. Combination treatment with iodine 125 seeds implant and systemic therapy can significantly improve clinical response and prolong two-year OS in NSCLC patients without increasing the incidence of myelosuppression and gastrointestinal symptoms, except pneumothorax. Key Words: Brachytherapy, Radioactive seeds, NSCLC, Systemic therapy.