Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2019
Distal Splenorenal Shunt (DSRS) in Children with Extrahepatic Portal Hypertension.
Portal hypertension (PH) is infrequent in children as compared to adults. Currently, repetitive endoscopic ablation of varices is standard treatment. ⋯ We reviewed the indications, operative morbidity, mortality, shunt patency and re-bleeding episodes in nine patients (age range 6-16 years, M:F 6:3) who had DSRS for recurrent GI bleeding not responding to endoscopic treatment and hypersplenism. DSRS is a safe and effective treatment alternative in resource limiting setting for preventing bleeding and improving hypersplenism in children with extrahepatic portal hypertension.
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A double-chambered right ventricle (DCRV) is a rare congenital heart defect. The clinical features of DCRV, especially in the pediatric population, have not been sufficiently elaborated. There are many unanswered questions regarding the surgical indications, surgical timing, natural history, and patient outcomes. ⋯ Symptomatic patients with an intra-right ventricular pressure gradient of >20 mmHg are indicated for a surgical repair. DCRV has a favourable postoperative course as no postoperative death was reported. Mechanisms of right ventricular obstruction warrant further elucidations based on larger patient population in the near future.
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J Coll Physicians Surg Pak · Dec 2019
Comparison of Various Abdominal Obesity Measures for Predicting Metabolic Syndrome, Diabetes, Nephropathy, and Dyslipidemia.
To evaluate abdominal volume index (AVI), body roundness index (BRI), body adiposity index (BAI), a body shape index (ABSI) and conicity index (C-Index) for differences in subjects with or without metabolic syndrome, diabetes, nephropathy, and dyslipidemia; and secondly, to evaluate the diagnostic performance through measuring area under curve (AUC) by ROC curve analysis for new and conventional obesity measures in diagnosing metabolic syndrome. ⋯ WHtR and AVI showed the highest AUC to diagnose metabolic syndrome and were better associated with metabolic diseases.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsPharyngeal Obturator Prosthetic Rehabilitation of Velopharyngeal Insufficiency.
Congenital or acquired defects of soft palate cause physical, functional and psychological disabilities. Surgical closure or prosthetic rehabilitation are the two treatment modalities. If surgery is contraindicated, prosthetic rehabilitation is the alternative treatment option. ⋯ In this case report, a young patient is treated for velopharyngeal insufficiency with pharyngeal obturator as the patient had refused to undergo surgical closure. The prosthesis was successfully fabricated and was evaluated for proper functioning. It improved speech, deglutition and psychological well-being of the patient.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsSigmoid Sinus Thrombosis with Cerebellar Tuberculous Abscess: A Rare Case of Chronic Headache with Vision Loss.
Cerebral venous sinus thrombosis (CVST) is a rare form of brain stroke which is often misdiagnosed. We present a case of CVST due to cerebellar tuberculous abscess. A 41-year female patient was admitted with chronic occipital headache, diminished vision, and fever. ⋯ Marked improvement (subjective and objective) was noted after 4 weeks with anti-tuberculosis chemotherapy and anticoagulants. Vision loss was irreversible due to optic atrophy. The case is extremely rare due to the location, rare causative organism (tuberculosis) and complex clinical presentation (occipital headache with vision loss).