Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Mar 2021
Sociodemographic, Clinical Characteristics, and Outcomes of Influenza Pneumonia Patients Admitted in a Tertiary Care Hospital in Karachi, Pakistan: Findings from a Cross-sectional Study.
To determine the sociodemographic, clinical characteristics, and outcomes of influenza pneumonia patients in tertiary care hospital, Karachi Pakistan. ⋯ Influenza pneumonia is very common in our population and older people are more likely to be affected by this disease. Patients can be prevented from adverse outcomes and complications, if diagnosed and treated in time. Key Words: Influenza, Clinical characteristics, Outcome, Patients.
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J Coll Physicians Surg Pak · Mar 2021
Incidence of Silent Ischemic Infarct after Diagnostic Conventional Cerebral Angiogram.
This study was carried out to determine the risk of new ischemic events, demonstrated by diffusion weighted magnetic resonance imaging (DW-MRI) in patients undergoing diagnostic conventional cerebral angiogram. MEDLINE, EMBASE, Current Contents, Cochrane Central, Expert Files, and bibliographies of included articles were systematically searched to identify prospective studies that reported MRI findings after diagnostic angiogram. Eligibility criteria included the following elements: manuscripts published between 1999 and 2019; prospective design; only diagnostic angiogram imaging performed prior to the MRI; DW-MRI done before and after the angiogram procedure; and number of new diffusion weighted lesions documented after each procedure. ⋯ DWI lesions were associated with diagnostic angiograms in 106 (24.65%) of total procedures. Mean time fluoroscopy, procedure by resident operator, and vascular risk factors were the recognised independent risk factors for silent cerebral ischemia after diagnostic angiogram. Key Words: Stroke, Diffusion magnetic resonance imaging, Cerebral infarction, Angiography, Brain ischemia.
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J Coll Physicians Surg Pak · Mar 2021
Review Case ReportsCervical HSIL Involving the Endometrium and Adenomyosis: A Case Report and Literature Review.
Cervical squamous cell carcinoma (SCC) spreading superficially to the inner surface of the uterus and replacing the endometrial lining cells with carcinoma cells is called superficial spreading SCC. We, hereby report a 53-year postmenopausal woman who had a history of cervical SCC in situ/high grade squamous intraepithelial lesion (HSIL). ⋯ This a very rare phenomenon, as the endometrial involvement may be caused by direct extension of the cervical lesion, and occur mainly in postmenopausal women, and should be deligently searched during pathological examination. Key Words: HSIL, Cervix, Endometrium, Adenomyosis.
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J Coll Physicians Surg Pak · Mar 2021
Dehydroepiandrosterone Sulfate (DHEAS) Levels in Polycystic Ovarian Syndrome (PCOS).
To compare DHEAS levels among subjects with and without PCOS, evaluating differences between lean-PCOS or obese-PCOS phenotype for insulin resistance, anthropometric indices, glycemic and lipid parameters. ⋯ DHEAS levels were high in lean-PCOS in comparison to obese-PCOS and non-PCOS females. However, receiver operating curve (ROC) analysis showed DHEAS as a weaker marker for diagnosing PCOS than FAI and modified FG score. Key Words: DHEAS, Polycystic ovarian syndrome (PCOS), Homeostasis model assessment for insulin resistance (HOMAIR), Rotterdam criteria, Free androgen index.
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J Coll Physicians Surg Pak · Mar 2021
Observational StudyEarly Surgical Management of Appendicular Mass in Pediatric Patients.
To find out the feasibility and safety of early surgery in pediatric patients who presented with appendicular mass. ⋯ This study was conducted on 60 children, who were diagnosed with appendicular mass. Patients were operated after initial stabilisation and investigations. Variables analysed included demographic characteristics, clinical presentation, intraoperative surgical difficulties and postoperative complications. Data were entered into SPSS version 22. Chi-square test and Fisher Exact test were used for finding statistical significance among variables. A p-value of <0.05 was considered as significant. Results: There were 41 (68.4%) male and 19 (31.6%) female patients with the mean age of 8.3 + 2.9 year. Mean duration of pain was 3.8 + 1.8 days. In 41 (68.4%) patients, mass was composed of appendix with adherent ileal loops and omentum, while in 19 (31.6%) patients frank pus was also found within the mass. Thirty-four (56.6%) patients had suppurative appendix without gross perforation, while in 26 (43.4%) patients partially sloughed / gangrenous perforated appendix found. Intraoperative difficulties were more in patients with complex mass (p=0.004). Postoperative complications were observed in 14 (23.3%) patients. These were more frequent in female patients (p=0.001), with sloughed, gangrenous perforated appendix (p=0.034) and complex mass (p=0.008). Superficial wound infection was the most common complication noted in 9 (15%) patients. In 5 (8.3%) children, deep seated intra-abdominal collections were found. The mean hospital stay was 3.4 + 1.5 days. Conclusion: Early surgery in pediatric patients with appendicular mass was found feasible with minimal complications. This obviated the need of prolonged follow-up and interval appendectomy with its inherent risks. Key Words: Appendicular mass, Appendicular lump, Appendectomy, Child.