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Journal of the College of Physicians and Surgeons—Pakistan: JCPSP

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https://www.readbyqxmd.com/read/30173706/hiv-negative-penile-kaposi-s-sarcoma-in-circumcised-men
#1
Ahmet Urkmez, Serkan Akan, Emrah Ozsoy
Kaposi's sarcoma (KS) is an inflammatory vascular tumor, which can be seen at multiple areas in the body, especially at skin and extremities, mostly in immunosuppressed patients like organ receivers and AIDS patients. It can also be seen in human immune deficiency virus (HIV) negative, heterosexual, circumcised and non-immunosuppressed patients; and the disease course may be very variable. Herein, we present three patients who were referred to our clinic in the last five years and had a rather different course of disease; they were heterosexual, circumcised, non-immunosuppressed, and HIV negative...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173705/a-case-of-multiple-myeloma-with-triple-herpes-virus-infections
#2
Misbah Noor, Saifullah Khan Niazi, Fatima Sana, Syed Kamran Mahmood
Multiple myeloma is rare B cell malignancy that affects elderly. Therapeutic regimens consist of high dose chemotherapy followed by haematopoietic stem cell transplantation (HSCT). Both humoral and cell mediated immunities are compromised in these patients, leading to increased susceptibility to infections. Here, we report a case of 62-year male with multiple myeloma who developed infection with three viruses from herpes family during the first cycle of chemotherapy.
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173704/diagnosis-and-treatment-of-paratesticular-adenomatoid-tumors
#3
Ahmet Urkmez, Serkan Akan, Emrah Ozsoy, Aytac Sahin, Orhan Koca, Metin Ishak Ozturk
Paratesticular adenomatoid tumor (PAT) is the most common paratesticular tumor. It is still a concern for today's urologists because it cannot be distinguished from malignant testicular tumors by clinical symptoms, routine examination and imaging methods. Because of the predominant benign nature of paratesticular masses, testicular preservative treatments get to the foreground. However, the fact that virtually all of the solid scrotal masses are malignant and are treated with radicel ingainel orchiectomy (RIO) remains a cause of concern...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173703/gunshot-injury-of-head-and-neck-region-with-an-atypical-bullet-trajectory-the-importance-of-whole-body-computed-tomography-scan
#4
Yusuf Velioglu, Ahmet Yuksel, Baris Durgun
Nowadays, gunshot injuries have become a common medical-legal issue because of easy accessibility of firearms. Gunshot injuries of head and neck region are highly morbid and fatal, particularly when they affect vital organs. In rare cases, atypical tract lines resulting from such injuries can cause difficulties in the diagnosis and treatment. In this report, a high energy gunshot injury involving head and neck region with an atypical bullet trajectory is presented. A 24-year male soldier was brought to the emergency department on account of gunshot injury following a conflict...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173702/a-case-study-on-the-effectiveness-of-cognitive-and-behavioural-approaches-for-diabetic-patient-with-cardiac-disease
#5
Asiya Khalid, Mahwesh Arooj Naz
Diabetes Mellitus is a non-infectious disease that is caused by insulin resistance. Current case provides a detailed account of a 45-year female diagnosed with diabetes and coronary heart disease having complaints of pain in her joints, sadness and worry, unable to control anger, loss of interest in previous pleasurable activities, reduced interaction with others, and difficulty falling asleep. After assessment, patient was diagnosed with 293.83 (F06.31) depression due to diabetes and coronary heart disease, with depressive features and V61...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173701/effects-of-combined-aerobic-and-virtual-reality-based-cognitive-training-on-76-years-old-diabetic-male-with-mild-cognitive-impairment
#6
Raana Ali Mirza, Irum Yaqoob
Aging, along with Type 2 Diabetes Mellitus (T2DM), is a risk factor for the development of mild cognitive impairment (MCI) among older adults. Physical activity is found beneficial for improving the cognitive status among adults with MCI and in even those having dementia. Combined aerobic-cognitive interventions are an engaging substitute or add-on to existing pharmacological management regimens. A 76-year diabetic male having MCI, followed 12 weeks of aerobics-virtual reality (VR)-based cognitive training programme (3days/week)...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173700/single-bilateral-undivided-tram-flap-for-a-bilateral-breasts-reconstruction-including-intermammary-presternal-skin-defect-coverage
#7
Junaid Ahmad, Roomana Akhlaque, Moazzam Nazeer Tarar
We present a case report of 30-year female presenting with a large skin and soft tissue defect of anterior chest wall, after bilateral mastectomy. Unlike other patients, she also had sternum defect after resection of skin of sternum. She had a 34x17 cm defect of anterior chest when she presented to us. We covered the defect and reconstructed bilateral breasts all with a single paddle bilateral delayed Transverse Rectus Abdominus Myocutaneous (TRAM) flap. Our flap paddle measured 42x21 cm and we observed no tip necrosis...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173699/hybrid-lesion-extralobar-sequestration-with-cystic-adenomatoid-malformation-misdiagnosed-as-pulmonary-tuberculosis
#8
Fatima Naumeri, Muhammad Nadeem Sajjad
We report a rare case of bronchopulmonary extralobar sequestration in a 9-year girl mimicking pulmonary tuberculosis. Patient had recurrent chest infections and two episodes of massive hemoptysis. Preoperative x-ray chest showed an opacity in left lower lobe and computed tomography-aortogram showed that the lesion had systemic arterial supply from celiac trunk. Diagnosis of pulmonary sequestration was made and left lateral muscle sparing thoracotomy was planned. Intraoperatively, extralobar sequestration was found with dual systemic blood supply...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173698/hybrid-lesion-of-congenital-cystic-adenomatoid-malformation-and-bronchopulmonary-sequestration
#9
Arshad Khushdil, Raazia Nawaz, Asma Razzaq, Naveed Ahmed
Hybrid congenital cystic lesions of lung comprising of both congenital cystic adenomatoid malformation (CCAM) and broncho-pulmonary sequestration (BPS) are very rare congenital malformations of the lung. We present a case of a newborn who presented to us with severe respiratory distress and later on found to have a hybrid lesion of the lung. It is a very rare occurrence and no such case has been reported from Pakistan so far.
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173697/enzyme-replacement-therapy-in-hypophosphatasia
#10
S. Ahmet Uçaktürk, Selin Elmaogullari, Sevim Ünal, Deniz Gönülal, Eda Mengen
Hypophosphatasia (HPP) is associated with significant morbidity and mortality in pediatric patients. The disease also imposes a high disease-burden in adult-onset HPP. Asfotase alfa (AA) is the first-in-class, bone-targeted, enzyme- replacement therapy designated to reverse the skeletal mineralisation defects in HPP. A male newborn presented with extreme fontanel gap and respiratory distress. He was diagnosed with perinatal lethal HPP thus AA treatment was started. Serum alkaline phosphatase (ALP) levels increased as high as 12,700 U/L during treatment...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173696/hereditary-hemorrhagic-telangiectasia-early-childhood-presentation-with-hepatic-failure
#11
Syeda Shaheera Hashmi, Nighat Haider, Munir Iqbal Malik
Hereditary hemorrhagic telangiectasia (HHT) is a vascular dysplasia in which capillary bed is absent with direct draining of arterial blood into venous circulation. Due to increased pressure there is increased risk of bleeding. The classical triad consists of telangiectasias, epistaxis and a positive family history. This defect can involve any organ system, especially lungs, brain and liver; but hepatic vascular malformations in HHT usually remain silent until fifth or sixth decade of life. However, if symptomatic, it usually results in only mild liver dysfunction in adults...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173695/mabry-syndrome-in-a-child-of-south-asian-descent
#12
Amir Humza Sohail, Muhammad Younus Khan Durrani, Shahnaz Hamid Ibrahim, Khadija Nuzhat Humayun
Mabry syndrome is the triad of seizures, hyperphosphatasia, and mental disability. It usually manifests in first year of life and has an autosomal recessive mode of inheritance. Besides the usual triad, other manifestations of Mabry syndrome include hypoplasia of distal phalanges, brachytelencepahly, gastrointestinal malformations and constipation, hypertelorism, short nose with a broad nasal bridge and dip, and thin upper lip with down turned corners of the mouth. More than 20 cases of Mabry syndrome have been reported in medical literature...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173694/proximal-tibial-osteochondroma-leading-to-chronic-compartment-syndrome
#13
Jitendra Wadhwani, Sumedha Vashishth, Ramchander Siwach, Rajesh Rohilla
Osteochondroma is the most common benign tumour of bone seen in 3% of the general population. Complications such as neurological compromise, skeletal defects, vascular lesions, and compartment syndrome occur in about 4% of osteochondromas. We bring forth the case of a 16-year male who presented with the complaints of swelling in calf region associated with symptoms of claudication and paraesthesias in leg after exertion and absence of any such complaints at rest. Radiographs revealed a bony pedunculated mass originating from the posterior tibial metaphyseal region causing compression of posterior soft tissue structures...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173693/multidisciplinary-approach-for-management-of-a-patient-with-oral-mucosal-malignant-melanoma
#14
Prashanti Eachempati, Himanshi Aggarwal, Vidya Kamalaksh Shenoy, Mohan Baliga
Oral mucosal melanoma is rare and more aggressive than cutaneous melanoma. Hard palate and maxillary alveolar crest are most commonly involved. Multidisciplinary team approach is necessary for successful management of this tumor. The main treatment modality is surgical resection, which usually results in impaired mastication, deglutition, speech, oral competence and significant cosmetic deformity. Here, a rare case of oral mucosal melanoma of mandibular gingiva in a 44-year man is reported, who was treated by en-block mandibular resection followed by adjuvant therapy with high dose interferons (IFN) - 2b...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173692/management-of-obstructive-sleep-apnea-syndrome-associated-with-severe-micrognathia
#15
Muhammad Nazir Khan, Muhamamd Adil Asim, Irfan Shah
Obstructive sleep apnea syndrome (OSAS), commonly associated with mandibular micrognathia, is a serious condition that can lead to various devastating cardiovascular and neurocognitive consequences. Patients of OSAS with micrognathia present with many functional and esthetic problems. Therefore, comprehensive management of these patients requires multiple surgeries and frequent follow-up. Several surgical and non-surgical treatment options have been proposed for the treatment of OSAS. Distraction osteogenesis (DO) in maxillofacial region, although a newer treatment modality, is being increasingly favoured by many surgeons because of its many advantages over other treatment methods...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173691/cerebral-abscess-caused-by-novel-species-streptococcus-pluranimalium
#16
Abeera Ahmed, Gohar Zaman, Adeel Gardezi, Luqman Satti, Nargis Sabir, Aliya Haleem
Streptococcus pluranimalium, a gram-positive aerobic coccus, has been isolated primarily from several farm animals. The pathogenicity of this species is not well characterised either in animals or humans. As per the literature, cases of S. pluranimalium infection in humans have been reported only a handful of times. We report the case of cerebral abscess caused by S. pluranimalium in a patient who presented with weakness and confusion. The diagnosis of cerebral abscess was made on imaging supported by microbiological culture...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173690/endovascular-aortic-repair-for-thoracic-aortic-injuries
#17
Omer Ehsan, Usama Khalid Choudry, Atif Rana, Zahid Amin Khan
Traumatic aortic injury (TAI) or aortic transection is the second most common cause of death after blunt trauma. The conventional management approach towards a thoracic aortic injury is open thoracotomy and surgical repair; however, there is a recent increase in the trend towards the use of endovascular approach in this regard, particularly in the developed countries. We here report the cases of two young healthy male patients presenting in emergency department with thoracic aortic injury, following a road traffic accident (RTA)...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173689/invasive-community-acquired-methicillin-resistant-staphylococcal-aureus-ca-mrsa-infections-in-children
#18
Muhammad Khalid, Samina Junejo, Fatima Mir
Staphylococci are gram-positive bacteria divided into coagulase positive and coagulase negative classes, Staphylococcus aureus is the most important bacterium of this class. Epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) has changed a lot. It is no more the problem of only hospitalised patients. Children coming from community has also been increasingly affected by MRSA-called community acquired methicillin-resistant (CA-MRSA) infection. The higher severity of CA-MRSA is due to its ability to produce the toxin Panton-Valentine Leukocidin (PVL) associated with staphylococcal cassette chromosome mec (SCCmec) type IV gene...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173688/an-unusual-presentation-of-langerhans-cell-histiocytosis
#19
Usama Rehman, Zafar Ali, Nadira Mamoon
Langerhans cell histiocytosis (LCH) is a rare entity formerly known as eosinophilic granuloma. It is characterised by clonal multiplication of langerhans cells (LCs) that can occur anywhere in the body, especially in connective tissue of skin, lymph nodes and bone. Although rare, the disorder frequently affects children. A 7-year male child presented with the complaint of swelling at glabella. CT-scan revealed a defect in the middle of both frontal bones with brain herniating out of it. The clinical differential diagnosis included osteomyelitis, Tuberculosis and encephalocele...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/30173687/thiamine-responsive-megaloblastic-anaemia-diabetes-mellitus-and-sensorineural-hearing-loss-in-a-child
#20
Ayesha Khurshid, Sarah Fatima, Chaudhry Altaf, Hamid Saeed Malik, Zunera Sajjad, Muhammad Tahir Khadim
Thiamine-responsive megaloblastic anemia (TRMA) syndrome is an autosomal recessive inherited disorder characterised by a triad of megaloblastic anemia, diabetes mellitus, and sensorineural deafness. We report a case of 2-year-old girl whose anemia improved following administration of thiamine. She came with the history of persistent anaemia for the last one year. Anaemia was not responding to iron, vitamin B12, and folate replacement therapy. The bone marrow aspiration revealed hypercellular marrow with megaloblastic changes and more than 15% ring sideroblasts...
September 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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