Pak J Med Sci
-
A 34-year-old non hypertensive, non-diabetic and ill looking weak woman came to our emergency department with shortness of breath NYHA III-IV, severe bilateral pedal edema extending up to the thighs and gross ascites. Physical examination revealed 3mm pitting ankle and leg edema and hemodynamically was stable with raised jugular venous pressure. There was a closing and opening mechanical click on Cardiac auscultation. ⋯ Prosthetic tricuspid valve was seen at tricuspid level with peak gradient of 22mmHg and shown stuck mechanical tricuspid discs stuck throughout the cardiac cycle, in a fully open position (Fig.2A and 2B). Atrial fibrillation was shown on ECG. The diagnosis was made as; pannus formation resulting in mechanical TV thrombosis.
-
Case Reports
Twin pregnancy with one normal fetus and one complete hydatidiform mole: Outcome of expectant management.
Twin pregnancy with one fetus and one complete mole falls amongst extremely rare obstetric situations. The spectrum of complications associated with it is wide. Once diagnosed, the choice between continuation and termination of pregnancy depends upon couple's preference and readiness to accept possible complications. ⋯ We present a case of twin pregnancy with complete hydatidiform mole and coexisting normal fetus diagnosed at 25 weeks. Pregnancy was complicated by anemia, gestational diabetes mellitus, recurrent vaginal bleeding, intrauterine growth restriction and iatrogenic preterm delivery. She was followed for development of GTN, none occurred.
-
Pain assessment plays a vital role in the management of patients across various healthcare settings. Accurate and reliable pain evaluation tools are essential for effective pain management and improving patient outcomes. The objective of this study was to assess ease of Full Cup Test (FCT) as a pain scale and to compare use of FCT with Visual Analogue Scale (VAS) for pain evaluation. ⋯ The Full Cup Test (FCT) emerged as a potentially valuable tool for assessing pain severity in a diverse range of patients. Regardless of age, gender, education level, and ethnicity, FCT demonstrated utility with ease in detecting pain severity.
-
To identify employee burn-out and assess its impact on patient safety culture. ⋯ Burnout was observed in employees, particularly high degree in attending physicians. However, team work, high level of personal accomplishment and incident reporting culture, served as protective factors for patient safety and safe working environment and culture.
-
We report a case of a 35 years old lady presenting with acute upper limb ischemia secondary to systemic lupus erythematosus (SLE), antiphospholipid syndrome (APLS) and infective endocarditis (IE). It is rare for SLE/APLS to present with acute limb ischemia (ALI) as the initial manifestation. The patient presented with high grade fever along with pain and numbness in her right upper limb. ⋯ After the patient's clinical deterioration and considering the severity of the ischemic condition, additional investigations were conducted, which ultimately led to the diagnosis of SLE with APLS. Management included antibiotic therapy for IE and high dose of IV steroids and anticoagulants for SLE/APLS, to which she responded well. This case emphasizes the significance of conducting a comprehensive evaluation of all possible causes of acute limb ischemia, while considering the patient's medical history and physical examination findings.