Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Jun 2021
Observational StudyResuscitative Thoracotomy as a Life-saving Intervention in the Emergency Department.
To investigate the survival rate and the return of spontaneous circulation (ROSC) in patients who underwent the resuscitative thoracotomy in the emergency department (EDRT), and determine the difference in survival rate of the patients who underwent EDRT with and without out of hospital CPR. ⋯ Performing EDRT increases the survival in penetrating injuries, especially in stab-wounds. Patients gain time for an advanced intervention. Furthermore, EDRT provides life guardians time to assess for organ donation when death is inevitable. Key Words: Blunt trauma, Cardiac arrest, CPR, Emergency thoracotomy, Gunshot injury; Organ donation, Resuscitation, Resuscitative thoracotomy, Stab-wound injury; Trauma resuscitation.
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J Coll Physicians Surg Pak · Jun 2021
Topical Ocular Anesthetic Use among Welders of Rawalpindi City, Pakistan.
A descriptive cross-sectional survey was done from January to June 2018 in welding shops of Rawalpindi city, Pakistan. The objectives of the study were to determine the frequency of topical ocular anesthetic use among welders and to assess the knowledge and practices of welders regarding safety measures. One hundred and fifty-eight welders from age group of 20 years and above, having welding work experience of more than one year, were included in the study. ⋯ Statistically significant association was found between knowledge and practices of welders regarding their safety measures (p<0.05). On binary logistic regression, work experience was found to be the strongest predictor of good knowledge (OR = 4.15, 95% CI = 1.45 - 12.15) and practices (OR=10.46 95% CI = 2.92 - 37.51). Key Words: Welder, Topical anesthetic abuse, Knowledge, Practices, Perceptions.
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J Coll Physicians Surg Pak · Jun 2021
Can Lymphovascular and Perineural Invasion be Additional Staging Criteria in Colorectal Cancer?
To identify additional staging information, venous, lymphatic, and neural invasion as potential prognostic factors in colorectal cancer (CRC). ⋯ LVI and PNI may be useful in identifying CRC patients who might benefit the most from adjuvant systemic therapy. On the other hand, the presence of LVI and PNI reflects a shorter patient survival. Key Words: Lymphovascular invasion, Perineural invasion, Colorectal cancer, Cancer staging.
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J Coll Physicians Surg Pak · Jun 2021
Case ReportsStreptococcal Pharyngitis: Delving Deeper than the Throat.
Acute rhabdomyolysis and elevated transaminases during streptococcal pharyngitis are rare presentations. The proposed pathophysiological mechanisms include direct bacterial invasion and toxin generation. Physicians should be aware of the association between these infections and the above-mentioned complications to facilitate optimal treatment of these patients. ⋯ Such high levels of creatine phosphokinase of 111856 IU/L and elevated liver function tests with aspartate aminotransferase (AST) of 1862 U/L and alanine aminotransferase (ALT) of 1003 U/L in streptococcal pharyngitis is rare to find in the literature. He was treated with aggressive intravenous hydration, antibiotics and hemodialysis. Key Words: Rhabdomyolysis, β-haemolytic Streptococci, Creatine phosphokinase, Liver function tests.
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To optimise the diagnosis and treatment of primary renal leiomyosarcoma, we present our experience with a similar case and review the literature. A 49-year woman was incidentally found to have a palpable mass in the right kidney. CT scan revealed an enhancing, heterogeneous, 6×7×9 cm right renal mass. ⋯ With unobvious clinical manifestations, preoperative imaging and postoperative pathological examination might be helpful for an accurate diagnosis. Radical nephrectomy to completely remove the tumor is recommended, and the combination of neoadjuvant or postoperative therapy should also be considered. Key Words: Renal neoplasms, Leiomyosarcoma, Diagnosis, Therapy.