Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsPersistent Left Superior Vena Cava: A Rare Finding for the Internists.
A case of a South Asian quinquagenarian gentleman is reported, who was admitted with septic shock and displayed a TYPE II persistent left superior vena cava (PLSVC) after insertion of a central venous catheter, diagnosed on the basis of chest X-ray findings and dilated coronary sinus on transthoracic echocardiography. As the patient was in septic shock, the central venous catheter was retained and vasopressor therapy was instituted with careful hemodynamic monitoring. ⋯ Treating physicians should be aware of a possible PLSVC, particularly when a guide wire or a catheter takes a left parasternal course. Key Words: Persistent left superior vena cava, Septic shock, Central venous catheter.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsBrucella Prosthetic Infection in a Patient with Total Knee Prosthesis.
Brucella infection is often an occupational disease of veterinarians, agricultural workers, and slaughterhouse workers. The infection is generally spread by contact of broken skin (open cuts or wounds) with infected animal tissues or by ingesting unpasteurized milk and dairy products from the infected animals. ⋯ We aim to present diagnostic and treatment approach of Brucella prosthetic infection in a 70-year woman with total knee arthroplasty. Key Words: Brucella, Prosthesis, Infection, Total knee arthroplasty.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsCarpometacarpal Joint Dislocations as a Rare Cause of Hand Pain.
Carpometacarpal joint dislocations represent not more than 1% of all hand injuries due to stable joint structures and high-energy trauma mechanism. Unfortunately, there are many missed cases suffering from ongoing pain and loss of function because of difficulty in diagnosis. Here we present a case of a healthy 42-year male who presented to the emergency department with hand pain after a punch injury. ⋯ In the case of carpometacarpal joint fracture or dislocations, early diagnosis and reduction are the most critical steps to avoid severe morbidity, and it is only possible with careful evaluation of physical and radiological findings. In conclusion, as seen in our case, emergency physicians should remain vigilant in the diagnosis and treatment of rare traumatic injuries. Key Words: Carpometacarpal joints, Dislocation, Hand injury, Pain.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsRecurrent Bleeding From a Duodenal Ulcer Halted by Laparoscopic Oversewing Under Endoscopic Guidance.
Peptic ulcers are the most common causes of upper gastrointestinal bleeding. Although most peptic ulcer bleeding can be controlled by medical and endoscopic treatment, a small number of patients with recurrent bleeding eventually require surgical treatment. In recent years, laparoscopy, a minimally invasive surgical method, has gained popularity and acceptance. ⋯ Laparoscopic oversewing of the bleeding ulcer under endoscopic guidance resulted in satisfactory recovery. We suggest that for recurrent bleeding from peptic ulcers, laparoscopic oversewing under endoscopic guidance should be recommended as a possible early option to halt the bleeding. Key Words: Upper gastrointestinal bleeding, Peptic ulcer, Laparoscopy, Treatment.
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J Coll Physicians Surg Pak · Aug 2022
Case ReportsA Novel Variant in Paired Box 3 Gene-related with Waardenburg Syndrome Type-1 in an Afghan Family.
Waardenburg Syndrome (WS) is a congenital auditory-pigmentary syndrome. We, herein, present a case of a 1.5 year girl presenting with bilateral hearing impairment. Detailed examinations and molecular analyses of the proband and other family members were performed. ⋯ No previous report of this variant was found in the literature and we determined the variant according to the guide published in 2015 as ''likely pathogenic''. We think that the clinical and genetic characterisation of the current family will contribute to knowledge for a better understanding of the genetic background of the Afghan patients with WS. Key Words: Waardenburg syndrome, Congenital auditory-pigmentary syndrome, PAX3 gene.