Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Dec 2022
Efficacy of Ganciclovir in Cytomegalovirus Retinitis via Intravitreal Route in AIDS Patients.
A series of nine eyes of five patients at LRBT Tertiary Teaching Eye Hospital, from July 2020 to June 2021 is reported. Five patients with high clinical suspicion of CMV Retinitis were treated with weekly intravitreal injections of 2.0 mg ganciclovir for 3 weeks. Pre- and post-injection visual acuity and clinical findings were noted. ⋯ Patients were followed up for a minimum duration of 1 year. Intravitreal ganciclovir is effective for CMV retinitis but follow- up for a longer duration is needed as these patients are prone to develop peripheral retinal tractions and detachments. Key Words: Ganciclovir, CMV retinitis, AIDS.
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HIV infections have always been a stigma, and the majority of transplant centres avoid liver transplantation in patients having end-stage liver disease patients with HIV coinfection. HIV patients with end-stage liver disease having undetectable HIV viral load, CD4+ cell count of >100/ml, and negative history of AIDS-specific opportunistic infections are considered suitable candidates for liver transplantation. Fulfilling the above-mentioned criteria, we performed successful living donor liver transplantation (LDLT) procedure on a 58-year-old gentleman who presented with end-stage liver disease and HIV coinfection. Key Words: HIV, Living donor, Liver transplantation.
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J Coll Physicians Surg Pak · Dec 2022
Case ReportsA Delayed Presentation of Arginase Deficiency Presenting with Status Epilepticus.
Arginase 1(ARG1) deficiency is a rare disorder of the urea cycle. The presentation is usually late, leading to loss of intellectual milestones, spasticity and liver involvement. Hyperammonemic crises are rarely encountered. ⋯ Molecular genetic analysis of ARG1 gene showed a novel homozygous mutation. Although the presentation of ARG1 deficiency is usually chronic in the majority of patients, an acute crisis of encephalopathy due to hyperammonemia may occur and delayed diagnosis may lead to irreversible neurological damage. Key Words: Urea cycle disorder, Hyperammonemia, Argininemia, Encephalopathy.
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J Coll Physicians Surg Pak · Dec 2022
EditorialAnxiety Disorders: Flying Under the Radar of Mental Health.
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A uterocutaneous fistula is a rare condition with a few reports in the literature. A 29-year female presented to our department with infected discharge at her previous Pfannenstiel incision. She was P3+1 with her last hysterotomy 16 months back due to previous two cesarean sections and missed miscarriage at 24 weeks of gestational amenorrhea. ⋯ Her laparotomy was done. The fistulous tract was removed and uterus was repaired successfully. Key Words: Fistula, Uterus, Hysterotomy.