Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Sep 2020
Observational StudySystemic Immune-inflammation Index is the Best Prognostic Factor in Patients with Advanced Stage Adenocarcinoma of the Lung Treated with Pemetrexed.
To evaluate the prognostic role of systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients who received platin-pemetrexed combination therapy and/or maintenance pemetrexed therapy. ⋯ In the univariate analyses, NLR-low group and SII-low group had significantly longer PFS compared to NLR-high and SII-high groups (10 months vs. 8 months, p=0.018, and 13 months vs. 8 months, p<0.001, respectively). The significant differences were seen between SII-low and SII-high groups for OS (24 months vs. 13 months, p=0.001). In multivariate analyses, response to treatment and low-SII were independent prognostic factors for PFS (HR: 0.25, p<0.001, and HR: 0.47, p=0.002, respectively) and OS (HR: 2.09, p=0.001, and HR: 2.05, p=0.001, respectively). Conclusion: SII is the most powerful of the three studied inflammatory indices, which could independently predict overall and progression-free survival. Key Words: Systemic immune-inflammation index, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Adenocarcinoma, Lung cancer, Pemetrexed.
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J Coll Physicians Surg Pak · Sep 2020
Case ReportsEarly Pneumopericardium after Endoscopic Thoracic Sympathectomy.
Pneumopericardium is a condition characterised by the presence of air within the pericardium. We hereby present a case of a rare potentially life-threatening complication, which is, to our knowledge, the first report of the pneumopericardium after single port endoscopic thoracic sympathectomy (SPETS). A 25-year male patient with a history of bilateral palmar hyperhidrosis underwent SPETS. ⋯ Based on clinical experience, routine postoperative clinical follow-up protocols should be established and applied for each patient following SPETS. Key Words: Palmar hyperhidrosis, Endoscopic thoracic sympathectomy, Pneumopericardium.
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J Coll Physicians Surg Pak · Sep 2020
Diagnostic Performance of One-hour Delta High Sensitive Troponin in Acute Coronary Syndrome.
To determine the impact of an increase in the level of high sensitivite (HS) troponin-I between the time of Emergency Department (ED) arrival and one-hour after arrival (0h-1h), and between the time of ED arrival and three hours after arrival (0h-3h), upon the diagnostic performance of HS troponin-I to correctly diagnose AMI. ⋯ Delta HS troponin I value in the first hour was nearly as sensitive for detection of an AMI as was delta HS Troponin I third-hour value. Key Words: Troponin, Myocardial infarction, Acute coronary syndrome.
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J Coll Physicians Surg Pak · Sep 2020
Observational StudySafety of Early Discharge after Primary Angioplasty.
To assess the safety of early discharge (less than 48 hours) in ST-segment elevation myocardial infarction (STEMI) patients treated with primary angioplasty (PA). ⋯ There were no differences between the early (<48 h) and delayed (>48 h) discharge groups in terms of adverse events. However, this might be due to an overall low event rates in the study. Key Words: ST-elevation myocardial infarction (STEMI), Primary angioplasty, Adverse event, Safety of early discharge after Primary PCI.
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J Coll Physicians Surg Pak · Sep 2020
Case ReportsKikuchi-Fujimoto Diseasae: An Important Differential of Tuberculous Lymphadenitis.
Kikuchi-Fujimoto disease, also called necrotising histiocytic lymphadenitis, is a rare disease of usually benign outcome. A case of a 21-year female is reported here. She presented with high grade fever and cervical lymphadenopathy. ⋯ Of significant note, two of patient's siblings were treated for pulmonary TB, because of which she had strong history of direct TB contact. Although a few cases of Kikuchi-Fujimoto disease have been reported in Pakistan, this is first case being reported in setting of very strong positive history of TB contact. Key Words: Lymphadenitis, Tuberculosis, Kikuchi-Fujimoto disease.