Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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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.
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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 ReportsDiagnostic Overlap of Brain Abscess Symptoms with Methamphetamine Withdrawal Symptoms.
From the perspective of forensic medicine, substance abuse is an important topic due to its nature and consequences. The usage of methamphetamine is a significant public health problem with deleterious side effects, one of the most serious of which is mimicking central nervous system infection. A 40-year man was brought to the emergency department with complaints of headache, vomiting, fever, and loss of consciousness. ⋯ A diagnosis of brain abscess and ventriculitis was made. The aim of this report is to draw physicians attention to substance abstinence symptoms that may mask more serious diseases. Key Words: Brain abscess, Methamphetamine withdrawal, Sinusitis.
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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
Healthcare Benefits of Preoperative Tamsulosin in Patients Before Ureteroscopy.
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