Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
-
J Coll Physicians Surg Pak · Jan 2021
Case ReportsProgressive Thoracic Kyphoscoliosis leading to Paraplegia in a Child with Neurofibromatosis Type-1.
In this case report we describe a case of a 13-year male with neurofibromatosis type-1, who had been suffering from progressive thoracic kyphoscoliosis that resulted in spinal cord compression and paraplegia. The report is meant to highlight the importance of timely detection and adequate follow-up of spinal deformities, associated with neurofibromatosis. Such deformities, if not effectively addressed, may progress corresponding to skeletal growth and lead to secondary problems, as was seen in our patient, who ultimately developed paraplegia. Key Words: Neurofibromatosis, Kyphoscoliosis, Paraplegia.
-
We present a case of coronavirus disease 2019 (COVİD-19) re-infection where the time interval between two COVİD-positive episodes is the longest in the literature. A 40-year male patient was admitted to the Emergency Department with complaints of sore throat, cough and diarrhea; and was re-diagnosed as COVİD-19 positive after a virus-free period. He did not have a chronic disease in his anamnesis and used no medication. ⋯ In this case, the time to second COVİD-19 infection was 94 days from the first positive PCR test and 86 days from the complete resolution of symptoms. This is one of the longest COVID-19-free period between two episodes of infection in the literature. Key Words: COVID-19, Recurrence, Re-infection, Recovery.
-
J Coll Physicians Surg Pak · Jan 2021
Case ReportsRight to Left Intrapulmonary Shunt in a Case with COVID-19-associated Pneumonia.
The clinical manifestations of coronavirus disease 2019 (COVID-19)-associated pneumonia show a wide range of variations. It ranges from mild hypoxemia without significant signs of respiratory distress, to rapid clinically deteriorating course with severe hypoxemia. Unexplained severe hypoxemia, associated with platypnea, triggers the possibility of ventilation-perfusion (V/Q) mismatch, ranging from intrapulmonary shunts (IPS) to alveolar dead space ventilation. ⋯ The clinical manifestations combined with nuclear imaging features enabled in making the ultimate diagnosis. The patient's clinical condition improved on appropriate clinical management, using high flow oxygen combined with intravenous steroids and anticoagulants. Key Words: COVID-19, Adult respiratory distress syndrome, Right to left shunt, Lung perfusion scintigraphy, Platypnea.
-
J Coll Physicians Surg Pak · Jan 2021
Mini-gastric Bypass Complications and the Value of the Preoperative Neutrophil to Lymphocyte Ratio in Early Prediction of Complications.
To describe the short-term results of mini-gastric bypass (MGB), the complications in patients who underwent mini-gastric bypass surgery (MGB), and evaluate the value of the neutrophil to lymphocyte ratio (NLR) in predicting complications at an early stage. ⋯ MGB is an effective procedure in obesity and diabetes surgery. Complications with high morbidity and mortality might be seen, although at low rates. Although NLR's efficacy is low in predicting MGB complications, it may be a useful parameter in a large series. Key Words: Bariatric surgery, Complications, Mini-gastric bypass, Morbid obesity.
-
J Coll Physicians Surg Pak · Jan 2021
Case ReportsVitamin D (Cholecalciferol) with Low Dose Vitamin C as a Safe and Effective Therapeutic Modality in an Adult with COVID-19 Pneumonia.
This is a case of an elderly female presenting with fever, cough and shortness of breath. On presentation, she had tachypnea and an oxygen requirement of 2 liters through nasal prongs. Her investigations were suggestive of COVID-19 pneumonia with bilateral ground-glass appearance on chest X-ray and a positive nasopharyngeal PCR swab. ⋯ On day 3, her symptoms completely resolved, and her chest X-ray improved. In patients with COVID-19 pneumonia, who are vitamin D deficient, administration of large doses of cholecalciferol for few days can be a safe option to treat mild to moderate COVID-19 pneumonia. Key Words: Vitamin D, COVID-19, Pneumonia, Vitamin C.