Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Sep 2020
Observational StudyPET-CT and MR Imaging in the Management of Axillary Nodes in Early Stage Breast Cancer.
To discriminate between malignant or benign axillary lymph nodes in breast cancer using MRI, PET-CT, and sentinel lymph node biopsy. ⋯ Combining PET-CT and MRI is superior to PET-CT or MRI imaging alone in distinguishing benign and malignant axillary lymph node; and contributes to deciding the approach to axillary lymph node surgery. Lymph node size is also important for this imaging method to determine benign and malignant nodes correctly. Key Words: Breast cancer, PET-CT, MRI, Sentinel lymph node biopsy, Axilla.
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J Coll Physicians Surg Pak · Sep 2020
Case ReportsChylous Ascites: A Rare Initial Presentation of Pancreatic Carcinoma.
Chylous ascites as first manifestation of pancreatic carcinoma is very rare. Usual presentations of pancreatic malignancy are abdominal discomfort, back pain, obstructive jaundice and duodenal obstruction. Development of chylous ascites during the course of the disease signifies poor prognosis. ⋯ Our patient developed chylous ascites early in the course of the pancreatic carcinoma. CT scan abdomen was non-conclusive and cervical lymph node biopsy later on revealed that the primary disease was occult pancreatic carcinoma. Key Word: Chylous ascites, Triglyceride level, Pancreatic carcinoma.
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J Coll Physicians Surg Pak · Sep 2020
Observational StudySystemic Immune-inflammation Index is the Best Prognostic Factor in Patients with Advanced Stage Adenocarcinoma of the Lung Treated with Pemetrexed.
To evaluate the prognostic role of systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) in patients who received platin-pemetrexed combination therapy and/or maintenance pemetrexed therapy. ⋯ In the univariate analyses, NLR-low group and SII-low group had significantly longer PFS compared to NLR-high and SII-high groups (10 months vs. 8 months, p=0.018, and 13 months vs. 8 months, p<0.001, respectively). The significant differences were seen between SII-low and SII-high groups for OS (24 months vs. 13 months, p=0.001). In multivariate analyses, response to treatment and low-SII were independent prognostic factors for PFS (HR: 0.25, p<0.001, and HR: 0.47, p=0.002, respectively) and OS (HR: 2.09, p=0.001, and HR: 2.05, p=0.001, respectively). Conclusion: SII is the most powerful of the three studied inflammatory indices, which could independently predict overall and progression-free survival. Key Words: Systemic immune-inflammation index, Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, Adenocarcinoma, Lung cancer, Pemetrexed.
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J Coll Physicians Surg Pak · Sep 2020
Randomized Controlled TrialNeurectomy versus Nerve Sparing in Open Inguinal Hernia Repair: A Randomised Controlled Trial.
To determine the effect of neurectomy in reducing the frequency of chronic inguinodynia after mesh hernioplasty in open inguinal hernia repair. ⋯ Excision of ilioinguinal and iliohypogastric nerve in inguinal mesh hernioplasty reduces the frequency of chronic inguinodynia. Ilioinguinal neurectomy may be practised routinely in patients undergoing Lichtenstein mesh hernioplasty. Key Words: Inguinal neurectomy, Inguinal hernia, Chronic inguinodynia, Lichtenstein mesh hernioplasty.