Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Apr 2018
Case ReportsA Case of Vogt-Koyanagi-Harada Syndrome Mimicking Optic Neuritis.
Vogt-Koyanagi-Harada syndrome is a rare disease that occurs commonly in pigmented individuals of Asian origin. A 25-year female presented in medical outpatient department (OPD) of Al-Khidmat Teaching Hospital, Mansoora, Lahore with headache and neck stiffness. She was referred to eye OPD for the complaint of decreased vision. ⋯ She was treated as a case of optic neuritis. Few days later, she developed bilateral panuveitis, shallow exudative detachments and alopecia. Clinical picture with normal magnetic resonance imaging (MRI) and laboratory tests helped us in reaching the diagnosis of Vogt-Koyanagi-Harada syndrome.
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Vitamin D deficiency is an emerging health concern around the world, highly prevalent in south Asian population, despite abundant sunlight. In Pakistan, all age groups are vulnerable to Vitamin D deficiency including pregnant women. This systematic review aimed to determine the pattern of Vitamin D deficiency among Pakistani pregnant women as well as exploring the causes and possible interventions that have had a substantial effect on improving the vitamin D level. ⋯ The main reasons for this were found to be avoiding sun exposure, quality of diet, and lower intake of calcium. Maternal vitamin D supplementation was found to be a key intervention to improve the maternal and neonatal vitamin D status. These review findings can be emerging in ensuring the adequate vitamin D level for Pakistani pregnant women during pregnancy, ultimately to achieve positive maternal and neonate's health outcomes.
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J Coll Physicians Surg Pak · Mar 2018
Case ReportsBipolar Affective Disorder in a Patient of Profound Deafness.
Profound deafness is a lifelong impairment, leading to the physical disability as well as poor psychological adjustment. We herein present a mental health disorder rarely seen among the patients of profound deafness. A 16-year deaf and dumb girl, previously treated for depression, presented with unusual laughter, irritability, flight of ideas, decreased sleep, ideas of self importance, and decreased social functioning and educational performance. ⋯ Marked improvement in the symptoms and social and educational performance was noted after two weeks of the treatment with sodium valproate, resperidone and clonazepam. Treatment options were explained to the patient with risks and benefits, and she was involved in the decision-making. This case report highlights the importance of accurately diagnosing and managing a rare mental health disorder among the physically handicapped people, especially those who cannot communicate effectively and explain their unusual subjective experiences.
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J Coll Physicians Surg Pak · Feb 2018
Utility of Diffusion Weighted Magnetic Resonance Imaging with Multiple B Values in Evaluation of Pancreatic Malignant and Benign Lesions and Pancreatitis.
To determine the feasibility of diffusion-weighted imaging in evaluation of pancreatic lesions and in differentiation of benign from malignant lesions. ⋯ Diffusion-weighted magnetic resonance images can be helpful in differentiation of pancreatic carcinoma and benign lesions. Lesion ADC / normal parenchyma ADC ratios are more important than lesion ADC values in assessment of pancreatic lesions.
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J Coll Physicians Surg Pak · Feb 2018
Distally Based Medial Hemisoleus Flap: Reliable Option for Distal Tibial Wounds.
To determine the success (flap survival as a whole without necrosis or dehiscence up to two months as judged clinically) of distally based medial hemisoleus muscle flap for the coverage of distal tibial defects. ⋯ Distally based medial hemisoleus muscle flap is reliable coverage option for middle and distal third of tibial defects.