Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2019
Assessment of Factors Influencing Lymph Node Count in Colorectal Cancer.
To evaluate the factors that influence pericolorectal lymph node (LN) retrieval from colectomy specimens in colorectal in cancer staging. ⋯ Tumor site and size, length of the surgical specimen, T-classification, depth of invasion and AJCC/UICC stage are predictors for the lymph node numbers in colorectal cancer surgery. Retrieval of removed nodes and counting helps in staging and number of removed nodes, and affects survival.
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Solitary papillomas of the lower airways are uncommon clinical entities that present a diagnostic challenge because they are not usually considered among the differential diagnoses. Reliable clinical data about their presentation and treatment remain scarce. We describe a case of an elderly male who presented to us with cough and hemoptysis. ⋯ Patient declined surgical removal of this papilloma. He was fine on followup visits during the subsequent months. In patients with hemoptysis, solitary endobronchial papilloma should also be considered in the differential diagnosis.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsHigh Grade Encapsulated Papillary Carcinoma of Breast in a Young Female.
Encapsulated papillary carcinoma (EPC) is a special type of papillary breast lesion known to be of low and intermediate grade. But recent data suggests existence of such tumors with high nuclear grade and mitotic index rendering them aggressive with chances of recurrence and lymph node metastasis which may alter the management of this tumor. ⋯ The subsequent radiologic findings showed a solid mass with cystic component and the patient underwent wide local excision along with excision of lymph nodes. Microscopy revealed a high-grade encapsulated tumor with papillary features; and a diagnosis of high grade encapsulated papillary carcinoma was given.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsA Patient of Advanced NSCLC with a New EGFR Exon 19 Insertion Mutation and its Response to EGFR-TKIs.
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) are the standard therapy for patients with advanced non-small-cell lung cancer (NSCLC) harbouring common EGFR mutations. However, about 10% of EGFR mutations are uncommon mutations and their response to EGFR-TKIs remains unclear. ⋯ In conclusion, patients harbouring new subtype of EGFR exon 19 insertion mutations, IPVAIL insertion may have a poor prognosis. Further experiences are required to characterise these uncommon mutations.
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J Coll Physicians Surg Pak · Dec 2019
A Simple Bed-side Method of Enteral Feeding through Distal Mucous Fistula in Patients with Short Bowel Syndrome to overcome Parenteral Dependency: The Jategaonkar Technique.
Today, massive proximal small bowel resection with diverting stoma formation is a relatively common occurrence, especially in an emergency setting. However, the resultant short bowel syndrome remains difficult to manage on various nutritional fronts and commencing total parenteral nutrition, along with plethora of its associated complications, becomes almost obligatory for these unfortunate patients. ⋯ Backed with successful experience of 18 cases, it is especially useful in low-income countries and can be mastered readily even by junior doctors, paramedic staff, and stoma therapists or by patient's kin, alike. Such a procedure is yet to be reported in the available literature.