Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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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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To evaluate the results of pars plana vitrectomy for cystoid macular edema (CME) resistant to medical treatment. ⋯ Pars plana vitrectomy with ERM / ILM peel and gas injection for CME refractory to medical treatment is an effective treatment. There was significantly improved best corrected visual acuity (BCVA) postoperatively along with decreased CMT on optical coherance tomography (OCT).
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsAnaesthetic Management of Cerebral Arterio-venous Malformation Excision Using Awake Craniotomy: Initial Experience of Two Cases.
This case series summarises the successful management of two cases with cerebral arterio-venous malformation (AVM). In first patient, it was located superficially in right frontal cortex, while the second one had this in left parieto-temporal region. Both were excised successfully using awake craniotomy. ⋯ Patients remained pain-free and hemodynamically stable during resection phase. The postoperative period showed adequate pain control, decreased postoperative nausea/vomiting and shorter length of stay in the hospital. Both patients had 100% obliteration of AVM confirmed via cerebral angiography.
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J Coll Physicians Surg Pak · Dec 2019
Case ReportsNeurolymphomatosis of the Sciatic and Tibial Nerves.
Neurolymphomatosis (NL) is an uncommon clinical condition, characterised by lymphomatous infiltration of the central and/or peripheral nervous system. Most often it is caused by B-cell non-Hodgkin's lymphoma (NHL). Clinically, patients usually present with neuropathy involving the nerve roots, plexuses, peripheral or cranial nerves. ⋯ It is important to diagnose and start early treatment in all cases of nodal or visceral (including neural) lymphoma with chemo and/or radiation therapy. The PET-CT and MRI can help in making diagnosis. We are presenting a case of 28-year male patient, diagnosed as diffuse large B-cell lymphoma on the background of follicular lymphoma, which initially responded to treatment but then presented with NL, based on clinical history and radiological findings which were confirmed by histopathology.
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J Coll Physicians Surg Pak · Dec 2019
Observational StudyNeurological Symptoms and Evaluation of Cerebral Blood Flow Changes with Synthetic Cannabinoids Use.
To describe the cerebral haemodynamic changes that occur in patients presenting to the emergency department (ED) after synthetic cannabinoid (SC) use in order to clarify the pathophysiology of neurologic adverse effects of SCs. ⋯ Cerebral blood flow and resistance changes due to SC use are likely to play a role in the main pathogenesis of the neurological symptoms, increasing the frequency of ischemic or haemorrhagic strokes.