Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · May 2020
Association of Comorbid Conditions with Six-month Survival and Disease Outcome in Patients of Necroinflammatory Otitis Externa.
To determine association of gender, causative organisms, control of diabetes, facial paralysis, infectious agent, and hearing loss with disease outcome, in terms of six-month improvement of symptoms, static condition or expiry of patients presenting with necroinflammatory otitis externa (NOE). ⋯ Previously pseudomonal infection was described as the only causative agent of NOE. This study showed a rising community-acquired disease with Staphylococcus aureus 6/10 (60%) and Pseudomonas 3/10 (30%) infection. Fungal infection is associated with poor survival and death, thus requiring aggressive management. Thinning of temporal bone on CT, uncontrolled diabetes, sever hearing loss and facial paralysis score V/VI were associated with poor outcome of disease. Key Words: Necroinflammatory otitis externa, Pseudomonas aeruginosa. Diabetes, Hearing loss, Facial paralysis, Temporal bone thinning, CT scan.
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J Coll Physicians Surg Pak · May 2020
Surgical Treatment of Gastric GIST: Feasibility of Laparoscopic Resection and Postoperative Outcome.
The aim of this study is to evaluate clinical manifestations and the possibility of laparoscopic treatment of large gastric stromal tumors. ⋯ Laparoscopic surgical procedures performed in experienced centres can also be applied to gastric tumors over 5 cm in well-selected cases without repercussions on survival. Key Words: Laparoscopy, Gastrointestinal stromal tumor, Gastric, Resection.
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J Coll Physicians Surg Pak · May 2020
Observational StudyEfficiency and Safety of The Retrograde Intrarenal Surgery in Younger Compared to Elderly Patients.
To determine the outcomes of retrograde ıntrarenal surgery (RIRS) and its complications in both young and elderly patients. ⋯ RIRS is a safe and effective method for treating kidney stones up to 3 centimeter diameter in all age groups. Although hemorrhagic events are mostly clinically unremarkable, there is a risk of renal function impairment in older (≥60 years) patients. Preoperative hydration and postoperative close follow-up is important. Key Words: Retrograde ıntrarenal surgery, Elderly, Effectiveness, Safety.
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J Coll Physicians Surg Pak · May 2020
Case ReportsTherapeutic Plasma Exchange Combined with Total Thyroidectomy to Rescue a Case of Thyroid Storm Intolerant to Antithyroid Drugs.
Thyroid storm is a syndrome related to acute exacerbation of thyrotoxicosis for which timely diagnosis and treatment are crucial. Importance of antithyroid drug therapy in thyroid storm patients has been emphasised in clinical treatments for a long time. These patients should receive definitive therapy for their underlying hyperthyroidism to avoid recurrence after controlling thyroid storm. ⋯ It confirms the significant benefits of therapeutic plasma exchange (TPE) when clinical conditions do not allow routine treatment of thyroid storm. This procedure is safe and effective when performed preoperatively as a rescue measure for thyroid storm patients. Key Words: Thyroid storm, Drug intolerance, Plasma exchange, Total Thyroidectomy.
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J Coll Physicians Surg Pak · May 2020
Case ReportsA Case with Neonatal-onset Type 2 Neuronal Ceroid Lipofuscinosis: A Novel Mutation.
Neuronal ceroid lipofuscinosis (NCL) is a lysosomal storage disorder that causes progressive neurodegenerative disease as a result of storage in neurons and other cells. Late infantile type (NCL Type 2) of NCL, which is the most common neurodegenerative disease in childhood, is characterised by a homozygous mutation in the tripeptidyl peptidase-1 (TPP-1) gene. A male infant was referred to our neonatal intensive care unit (NICU) on 26th day of life with a diagnosis of metabolic disease. ⋯ A novel homozygous pathological mutation was detected in exon 9 of the TPP-1 gene. With this case, it should be kept in mind that NCL may rarely start early in neonatal period and should be suspected in newborns with cerebral and cerebellar atrophy for early diagnosis. Key Words: Hypotonia, Lysosomal storage diseases, Metabolic disease, Neuronal ceroid lipofuscinosis, Newborn.