Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2022
Dyna-CT-based Image Fusion Technique Real-time-assisted Percutaneous Micro-balloon Compression in the Treatment of Trigeminal Neuralgia.
To investigate the efficacy and safety of percutaneous micro-balloon compression (PBC) assisted by Dyna-CT-based image fusion technique in the treatment of trigeminal neuralgia (TN). This study is the retrospective analysis of the efficacy and safety of 18 patients with TN treated by PBC assisted with Dyna-CT-based image fusion technique from May 2020 to May 2021. The puncture route from the skin to the foramen ovale（FO）was reconstructed after Dyna-CT scanning; and the puncture direction was adjusted according to the virtual puncture route until the puncture was completed. ⋯ Importantly, pain was relieved in all patients, and no puncture-related complications occurred. Dyna-CT-based image fusion real-time-assisted PBC for the treatment of TN is safe and effective, making the operation easier and faster, greatly improving the success rate of the puncture, and reducing the risk of operation-related complications. Key Words: Dyna-CT, Percutaneous micro-balloon compression, Trigeminal neuralgia.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsNeuroleptic Malignant Syndrome with Normal Creatine Phosphokinase Levels: An Atypical Presentation.
Neuroleptic malignant syndrome (NMS) was initially notified as an adverse effect of an antipsychotic agent called chlorpromazine, in 1956. In the past, several case reports of NMS have been reported, even if they did not meet the proposed diagnostic criteria for it. The diagnostic criteria for NMS include increased muscle stiffness, increased body temperature, elevated creatine phosphokinase (CPK) levels by at least four times the upper limit of normal (ULN), autonomic dysfunction, and an altered mental status. ⋯ Persistent hyperthermia and autonomic symptoms with further deterioration in mental status, led to a working diagnosis of NMS. The patient, thereafter, received bromocriptine, benzodiazepines and continuous intravenous hydration, but his clinical condition deteriorated and he expired after nine days of hospital stay. Key Words: Neuroleptic malignant syndrome, Creatine phosphokinase, Hyperthermia, Muscle stiffness.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsAn Extraordinary Case of Isolated Duodenal Injury after Blunt Abdominal Trauma.
Duodenal injuries are rare due to their preserved retroperitoneal location. They are mostly observed after deep penetration or high-impact blunt trauma. They are difficult to diagnose and treat. ⋯ Imaging findings of retroperitoneal organ injuries can be non-specific. We suggest that surgical exploration should be the first choice of treatment in cases with acute abdomen findings. Key Words: Blunt trauma, Acute abdomen, Duodenum, Retroperitoneum.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsMalignant Peripheral Nerve Sheath Tumor of the Cervix.
The occurrence of primary malignant peripheral neurilemmoma in the female cervix without neurofibromatosis type 1 is extremely rare. We, herein, report a case of a 46-year woman with malignant peripheral nerve sheath tumor (MPNST) involving the cervix. The patient was admitted to the hospital because of irregular vaginal bleeding. ⋯ The patient was treated with surgery, multi-line chemotherapy and targeted therapy, but the overall survival (OS) was 44 months. It is the first reported case of cervical MPNST receiving combined treatment. Key Words: Malignant peripheral nerve sheath tumor, Cervix, Pulmonary metastasis, Hysterectomy, Chemotherapy.
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J Coll Physicians Surg Pak · Apr 2022
Case ReportsSimple Congenital Hamartoma of Retinal Pigment Epithelium.
A 45-year female presented in the Outpatient Department of a tertiary care hospital of Lahore with dimness of vision in the right eye. Her history revealed that the patient had noticed decreased vision since her childhood. Fundus examination revealed a jet-black slightly raised lesion about the size of ¼-disc diameter, located in the centre of macula. ⋯ Choroid and surrounding retina was normal in our patient, which was helpful in differentiating it from choroidal nevus/choroidal melanoma. Our final diagnosis was simple congenital hamartoma of RPE. Key Words: Hamartoma, Retinal pigment epithelium, Macula.