Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Nov 2021
The Influence of OPRM1 A118G Polymorphism on the Dosage of Morphine in Patients with Advanced Liver Cancer.
This study was conducted to investigate the influence of μ-opioid receptor gene (OPRM1) A118G polymorphism on dosage of morphine in advanced liver cancer patients. Seventy patients with advanced liver cancer at Changyi People's Hospital, Shandong Province, China, were included from February 2019 to December 2020. The dosage of morphine in patients with OPRM1 A118G different genotypes was compared. ⋯ In conclusion, OPRM1 A118G genotype may affect the dosage of morphine in advanced liver cancer patients. More dosages of morphine are needed for pain control in patients with G allele. Key Words: μ-opioid receptor gene (OPRM1), Gene polymorphism, Liver cancer, Morphine.
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J Coll Physicians Surg Pak · Nov 2021
Case ReportsUse of Eculizumab in Thrombotic Microangiopathy Associated with Hematopoietic Stem Cell Transplantation.
Thrombotic microangiopathy (TMA) associated with hematopoietic stem cell transplantation, remains a difficult complication due to its high mortality rate, lack of standardised diagnostic criteria, and limited treatment options. Although the etiology of the disease is not clear, medications, radiotherapy, graft-versus-host disease (GVHD), angioinvasive fungal, viral infections and complement activation have been implicated. Agents such as therapeutic plasma exchange (TPE), steroids, rituximab, defibrotide, eculizumab are used in its treatment. ⋯ As there is no standard dose for eculizumab in the treatment of TA-TMA, doses used in atypical hemolytic uremic syndrome (aHUS) were administered. In this paper, we present a case that was unresponsive to TPE and steroids, but which was successfully treated with eculizumab. Key Words: Acute myeloid leukemia, Stem cell transplantation, Thrombotic microangiopathy, Apheresis, Eculizumab.
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J Coll Physicians Surg Pak · Nov 2021
Case ReportsA Rare Case of Posterior Interosseous Nerve Palsy Post-venepuncture.
Wrist drop post-venepuncture is uncommon. There has been reported cases of direct injury to the radial nerve during venepuncture but to our knowledge, there has never been a case of posterior interosseous nerve (PIN) injury. A 34-year female, right hand dominant homemaker, with a newly diagnosed diabetes mellitus, was admitted for diabetic ketoacidosis. ⋯ Despite the transient blood taking session, patient developed neuropraxia, which only resolved after four months. We wish to report this case of unusual presentation of a PIN palsy post- routine venepuncture, which can result in high morbidity to a patient. Key Words: Posterior interosseous nerve syndrome, venepuncture, neuropraxia, wrist drop.
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J Coll Physicians Surg Pak · Nov 2021
Philadelphia Chromosome Positive B-lymphoblastic Leukemia in an Infant.
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J Coll Physicians Surg Pak · Nov 2021
Case ReportsAdult Retroperitoneal Mature Cystic Teratoma Masquerading as Non-Endocrine Primary Adrenal Tumor.
Teratomas belong to non-seminomatous germ cell tumors and originate from totipotent germ cells. They are mostly made up of tissues derived from all three layers, i.e., endoderm, mesoderm and ectoderm. They can be mature teratomas, which are benign or immature teratomas, having malignant potential. ⋯ She was found to have a large retroperitoneal mass in adrenal region producing mass effect on intestines. Later on, it was discovered to be mature cystic teratoma on histopathological evaluation. Key Words: Mature teratoma, Adrenal gland, Retroperitoneum.