Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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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.
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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
Vitamin D Levels and Bone Mineral Density in Inborn Errors of Metabolism Requiring Specialised Diets.
To evaluate vitamin D levels and bone mineral density in patients with dietary limitations due to inborn errors of metabolism (IEM) and its correlation with diets. ⋯ Low BMD may be encountered in IEM, independent of vitamin D levels and revision of diet for adequacy of essential nutrients; and follow-up for dietary compliance is inevitable.
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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).