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Hidden Deficiency: How Metformin Use Drives Vitamin B12 Depletion in Type 2 Diabetes
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Diagnosis and Treatment of Polycythemia Vera in Pakistan; Barriers and Possible Solutions
Full text linkThis review aims to highlight the challenges encountered in managing Polycythemia Vera in resource-limited settings and to suggest a cost-effective strategy for timely diagnosis and treatment. Presentation to healthcare facilities at an advanced stage due to lack of awareness and limited access to medical care, delay in the diagnosis due to inadequate healthcare infrastructure, unavailability of molecular testing in the majority of centers, and suboptimal disease management, primarily due to lack of physician awareness and expertise in handling this condition are the key factors contributing to the higher rates of complications, including thrombotic events and disease progression, ultimately leading to poorer patient prognoses in Pakistani population. This review describes and evaluates a cost-effective diagnostic and treatment approach to Polycythemia Vera to reduce the morbidity and mortality of the disorder in Pakistan. A tailored investigation plan comprising of JAK2 mutation and serum erythropoietin levels and minimal cytoreductive therapy combined with phlebotomy and anti-platelet agent can be implemented to achieve optimal management of the disease in a resource-constrained country
Proteinuria Ratio and Related Factors İn Type 2 DM Patients: A Hospital-Based Study in Somalia
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Advancing Neonatal Care: The Importance of Kangaroo Mother Care for Preterm Infants
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Person Centred Care in Primary Practice
Full text linkEnsuring delivery of good quality health services at the primary care level is important if we wish to improve overall health of the community. One of the pillars of quality assessment is person centred care. Person centred care is that which respects responds to, and resonates with, the necessities and needs of the individual seeking health care. In this review, we describe the various definitions of person centred care, and explore its scope and spectrum, as related to primary care. We suggest ways of incorporating person-centricity, and thus improving satisfaction with health care services in South Asia
A Rare Encounter: Intra-Abdominal Seminoma Rupture in an Undescended Testis Leading to Hemoperitoneum
Full text linkIntra-abdominal seminomas arising from an undescended testis are uncommon. They are often mistaken for mesenteric or retroperitoneal sarcoma. Undescended testes are a common birth anomaly. Approximately 10% of undescended testes are located in the abdominal cavity, and an intra-abdominal testis is reported to have a higher risk of testicular cancer than an inguinal testis. We present a case of a 52-year-old man who arrived at the Emergency Department of Liaquat National Hospital with acute abdominal pain. A CT scan revealed an intra-abdominal rupture of the seminoma in the undescended testis with hemoperitoneum
Estimating the Impact of Associated Factors on Women's Absenteeism from School or Work due to Inadequate Menstrual Hygiene Management
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Angioembolization of Uterine Arteriovenous Fistula- a Case Series
Full text linkUterine arteriovenous fistulas (AVFs) are rare but clinically significant vascular abnormalities that can lead to severe, sometimes life-threatening, vaginal bleeding, particularly in women of reproductive age. Prompt diagnosis and treatment are essential to prevent serious morbidity. Radiologic imaging is the mainstay of diagnosis, revealing increased and abnormal uterine vascularity. Three principal treatment approaches are available: (i) Medical management, including hormonal therapy, methotrexate, or uterotonics; (ii) Interventional radiology, particularly uterine artery embolization (UAE); and (iii) Surgical management, most notably hysterectomy. Clinical presentation often includes irregular or profuse per-vaginal bleeding, which may result in hemodynamic instability, necessitating transfusion or emergency intervention. Given the condition's prevalence among women wishing to preserve fertility, minimally invasive options like UAE are preferred. Angiography serves as both a diagnostic and therapeutic tool, aiding in the localization and embolization of AVFs. This paper presents ten cases of uterine AVFs diagnosed through imaging and managed with UAE, followed by an analysis of clinical outcomes and implications for fertility preservation
