Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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Spinal cystic schwannomas are a very rare entity and have been reported in only a few case reports in literature; its diagnosis and management has remained a challenge. This study reviewed the results of magnetic resonance imaging (MRI) of 12 patients (7 men and 5 women; aged 37 - 67 years; mean age: 52.75 years) with pathologically proven cystic schwannoma of the spine and discussed their differential diagnosis. ⋯ MRI showed well-delineated intradural and extramedullary lesion of iso- to low signal intensity on T1 weighted images, high signal intensity on T2 weighted images, and rim enhancement on contrast-enhanced images. A precise understanding of the MRI features of spinal schwannomas, especially the typical characteristic of enhancement, may help clinicians in their pre-operative diagnoses and surgical planning.
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J Coll Physicians Surg Pak · Jan 2014
Time for change: conventional interferon regimes should not be the standard of care for management of Pakistani genotype-3 in chronic hepatitis C.
The aim of the present study was to determine the efficacy and side effect profile of conventional interferon alpha-2b plus ribavirin for treating chronic hepatitis C genotype-3 infections in Pakistan. The study was conducted on treating 220 treatment-naïve individuals at KRL Hospital with conventional interferon given for 6 months. ⋯ Leukopenia, gastrointestinal and miscellaneous systemic complaints were the most common adverse effects. In the context of a low ETR and SVR but a similar side effect profile as that of pegylated regimes, conventional therapy needs to be replaced with peg-interferon as the treatment of choice.
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Thyroidectomy is usually performed under general anaesthesia with endotracheal intubation. Bilateral cervical plexus block has been occasionally used as sole anaesthesia technique for this operation in certain parts of world. Indications for regional anaesthesia elsewhere in the world are patient's preference and associated marked cardio-respiratory disease. ⋯ Total thyroidectomy was done while patient remained painfree during the procedure and top-up local anaesthetic infiltration was not required. Patient remained stable without any morbidity. Positive experience from this case indicates that regional anaesthesia with monitored anaesthesia care is safer than general anaesthesia in high risk patients and could be offered to selective thyroidectomy candidates.
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J Coll Physicians Surg Pak · Dec 2013
Randomized Controlled Trial Observational StudyUnilateral approach for bilateral decompression of lumbar spinal stenosis: a minimal invasive surgery.
To assess the feasibility and efficacy of a novel, minimally invasive spinal surgery technique for the correction of lumbar spinal stenosis involving unilateral approach for bilateral decompression. ⋯ The ultimate goal of the unilateral approach to treat lumbar spinal stenosis is to achieve adequate decompression of the neural elements. An additional benefit of a minimally invasive approach is adequate preservation of vertebral stability, as it requires only minimal muscle trauma, preservation of supraspinous/intraspinous ligament complex and spinous process, therefore, allows early mobilization. This also shortens the hospital stay, reduces postoperative back pain, and leads to satisfactory outcome.
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J Coll Physicians Surg Pak · Dec 2013
Comparative StudyOral white lesions: presentation and comparison of oral submucous fibrosis with other lesions.
To compare oral submucous fibrosis with other white oral lesions for presentation and associated factors. ⋯ OSF was the predominant white lesion in patients examined at DIKIOHS. Areca nut was found to be chewed more by patients with OSF and still longer by patients with SCC.