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Initiation of Antenatal Care, Content of Care Received and Determinants for Early Visit -An Opportunity Still Missed in Pakistan
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Incidental Finding of Bladder Carcinoma during Stone Removal: A Rare Correlation and Upcoming Physician Challenge
Get PDFVesical calculi and bladder carcinomas have rarely been correlated and addressed in the literature. Recent publications have noted an association between the two as an upcoming physician challenge. Vesical calculi are now categorized as an etiological factor in bladder carcinogenesis. Chronic bladder stones appear to play a pivotal role in the disruption of the bladder mucosal epithelium. Bladder carcinoma findings tend to be incidental during stone removal; multiple large-scale studies are needed to identify dysplastic changes at an earlier stage.
Screening biopsies and cystoscopies aid in the preliminary diagnosis of bladder tumors. Despite vesical calculi comprising 5% of the cases of urinary tract stones, no effective rationale has been developed to prevent this lethal complication of prolonged stone disease. The size and weight of calculi have been identified as determinants of neoplastic changes. Urinary tract infections have been strongly correlated with the concomitant occurrence of bladder stones. Repeated UTIs may warrant the need to diagnose the presence of calculus and initiate therapeutic intervention. Active surveillance will likely be beneficial for patients with a chronic history of frequent UTIs and bladder stone disease
Impact of Counselling and Consent on Patient’s Satisfaction at a Tertiary Care Hospital in Karachi, Sindh
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Evaluation of Knowledge Regarding Rheumatic Fever and Its Prevention among Doctors at a Tertiary Cardiac Care Unit
Get PDFBackground: Rheumatic heart disease is one of the most frequent types of acquired heart disease, and it is one of the leading causes of morbidity and death. Awareness of doctors regarding rheumatic fever and how to prevent it is important for primary and secondary prevention
Dermatofibrosarcoma Protuberance (DFSP) of Parotid Gland – A Case Report
Get PDFDermatofibrosarcoma protuberans (DFSP) is a rare slow-growing low-grade dermal sarcoma typically found on the chest or proximal extremities. Uncommon sites include the head, face, and neck area. This tumor is locally invasive but has low distant metastasis. DFSP shows CD34 immuno-reactivity and hence required tissue biopsy for diagnosis. The case describes an unusual occurrence of dermatofibrosarcoma protuberance arising from the parotid gland
A Rare Occurrence of Postural Hypotension in a COVID-19 Patient
Get PDFThe SARS-CoV-2 infection has presented itself with typical presentations like other viral infections and atypical presentations as well. Many of the clinical associations are established and still, researches are ongoing. It is still an evolving disease and is an area of research at present time. We present a rare case of postural hypotension in a 49-years-old COVID-19 patient.
We admitted a 49-year-old diabetic male patient with a history of acute onset shortness of breath, cough and fever. The patient was diagnosed case of a COVID-19 infection and was admitted with mild to moderate symptoms. The patient maintained his normal saturation on oxygen. The patient developed an unusual symptom of postural hypotension during his hospital stay and it was managed with a conservative approach. The development of postural hypotension in a COVID-19 patient is reported very rarely. Given the fact that postural hypotension is an important and specific disease entity, this association presents an active area of research in the present era
Ethnic Differences in the Expression of HER2/neu Phenotype Among Women with Breast Cancer
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Duodenal Adenocarcinoma – A Rare Encounter and Management in a Young Male
Get PDFA rarely encountered tumor, Duodenal Adenocarcinoma (DA) has a poor prognosis with a 5-year survival rate at 30%. DA usually occurs in the older age group; it is diagnosed at an average age of 60 years. DA with peritoneal dissemination in a younger population has not been well reported in the literature review, so we are reporting this case. The carcinoma was diagnosed in the third segment of the duodenum (D3) with associated peritoneal carcinomatosis. The patient presented with abdominal pain, nausea, weight loss, and other symptoms with a history of cholecystectomy for his prior abdominal complaints. A large, obstructive, ulcerated mass in the third segment of the duodenum (D3) confirmed the presence of a DA. A palliative gastrojejunostomy was performed, followed by Whipple procedure with hyperthermic intraperitoneal chemotherapy (HIPEC). After surgery, the patient presented with postoperative complications including ascites and perforation of the sigmoid colon. On subsequent follow-ups, patient was well; however, one year after Whipple’s procedure, there was a recurrence in the form of lung nodules.
Besides being one of the rarest malignancies, DA is significantly scarce in the younger subset. The key to a better outcome involves an aggressive approach with an early diagnosis. Lymph node assessment is an important prognostic factor. No positive correlation has been established between adjuvant chemotherapy and survival rates. Peritoneal dissemination from DA is uncommon. HIPEC, although a reasonable therapeutic strategy for disseminated peritoneal carcinomatosis, resulted in sigmoid perforation