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 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
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 ReportsA Rare Complication of Brucellosis: A Case of Acute Cholecystitis.
Brucellosis is a common zoonotic disease in the world and in Turkiye. The disease is transmitted to humans through ingestion of unpasteurized animal milk products or direct contact with infected tissues or fluids. ⋯ Herein, we report a case of acute cholecystitis, a rare complication of brucellosis, presenting with fever, abdominal pain, and elevated liver enzymes. Key Words: Acute cholecystitis, Brucellosis, Zoonoses.
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J Coll Physicians Surg Pak · Jan 2023
Randomized Controlled TrialPerioperative Intravenous Lidocaine Infusion for Postlaparoscopic Cholecystectomy Pain.
To compare intravenous lidocaine infusion adjunct to NSAID and Acetaminophen with regular analgesics for postoperative mean pain score and mean ambulation time after laparoscopic cholecystectomy. ⋯ Ambulation time, Laparoscopic cholecystectomy, Postoperative pain.