Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Mar 2021
Observational StudyDalteparin and Rivaroxaban Sequential Use in Cancer Patients with Venous Thromboembolism.
To determine the effect and safety of sequential treatment with the low-molecular-weight heparin dalteparin and the direct oral anticoagulants rivaroxaban in patients with cancer- associated venous thromboembolism (VTE). ⋯ Maintenance of rivaroxaban after initial dalteparin treatment could effectively reduce the risk of VTE recurrence and was well tolerated by patients with cancer-associated VTE. However, in the clinical practice, the treatment duration is often insufficient, so it is essential to follow-up these patients to ensure sufficient treatment time. Key Words: Venous thromboembolism, Low-molecular-weight heparins, Directly oral anticoagulants, Cancer.
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J Coll Physicians Surg Pak · Mar 2021
Case ReportsNon-operative Treatment of Gastric Fistula after Splenectomy Combined with Pericardial Devascularisation in Portal Hypertension.
Portal hypertension may gradually lead to esophagogastric varices and splenomegaly in the decompensated stage of liver cirrhosis, which requires surgical treatment, if the disease worsens. Splenectomy with pericardial devascularisation is the routine surgery. One complex complication after splenectomy is upper gastric fistula which can seriously affect the perioperative recovery. ⋯ The occurrence of gastric fistula may be strongly related to preoperative preparation, intra-operative procedure and postoperative management. Therefore, personalised management is important for avoiding gastric fistula. Key Words: Gastric fistula, Splenectomy, Pericardial devascularisation, Portal hypertension.
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J Coll Physicians Surg Pak · Mar 2021
Case ReportsAngioembolisation for the Treatment of Pseudo-aneurysm of Internal Maxillary Artery.
Pseudo-aneurysm of internal maxillary artery, following a road traffic accident, is a rare clinical scenario. The consequence of pseudo-aneurysm may be spontaneous rupture of the arterial wall, which may eventually lead to life-threatening hemorrhage. ⋯ Similar cases of traumatic pseudo-aneurysms have been reported, however, none presented with recurrent epistaxis after management of pan-facial fractures. Key Words: Epistaxis, Pseudo-aneurysm, Angioembolisation, Pan-facial fracture.
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J Coll Physicians Surg Pak · Mar 2021
Ultrasound-assisted Percutaneous Vertebroplasty in Upper and Mid-thoracic Osteoporotic Fracture.
Osteoporotic vertebral compression fracture (OVCF) is a common disease among the elderly individuals. With the aging of the population development, the incidence of OVCF is increasing. Cementation of vertebral body like percutaneous vertebroplasty (PVP) is a minimally invasive and effective treatment. ⋯ Inaccurate puncture and high radiation exposure of PVP in upper and mid-thoracic vertebrae still challenge surgeons. Owing to the ability of musculoskeletal ultrasound in revealing the clear real-time view of soft tissues and skeleton, the authors use intraoperative ultrasound-guided PVP to treat eight patients with upper or mid-thoracic vertebra body OVCFs, which has been tested to be a safe, feasible and satisfied technique after the operation and follow-up. To the authors' knowledge, this technique has not been reported elsewhere. Key Words: Ultrasound, Percutaneous vertebroplasty, Osteoporotic vertebral compression fracture, Upper and mid-thoracic vertebra body.
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J Coll Physicians Surg Pak · Mar 2021
Observational StudyAn Evaluation of the Effect of Preoperative Inflammation-based Factors on Survival in Gastric Cancer Patients.
To investigate the predictive effect of preoperative inflammatory factors on overall survival (OS) in patients diagnosed with gastric adenocarcinoma (GAC). ⋯ Inflammation-based factors including AST-ALT ratio and albumin can help assess prognosis in patients with gastric cancer in standard clinical preoperative tests. Key Words: Gastric cancer, Inflammation-based factors, Aspartate transaminase-alanine aminotransaminase ratio, Neutrophil-lymphocyte ratio, Platelet-lymphocyte ratio, Albumin, Tumor-node-metastasis staging, Overall survival.