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Spinal Surgery- Use of Dexmedetomidine for Myasthenia Gravis - A Case Report
Get PDFMyasthenia gravis (MG) is a chronic autoimmune disease in which autoantibodies destroy acetylcholine receptors at motor end plat of neuromuscular junction which prevent skeletal muscle depolarization and contraction, causes muscle weakness and tiredness upon exertion with a tendency to be subsided after taking some rest or after taking anticholinesterase medication. Symptoms of progression of MG include the involvement of upper and lower extremities and muscle weakness that leads to inability in doing basic motor functions. The diagnosis of myasthenia gravis includes sign and symptoms, clinical examination and laboratory investigation of serum autoantibody (AChR autoantibodies) implicated in the disease pathology. Surgical procedures under general anesthesia in a patient with MG could be very challenging for an anesthetist because of pathophysiological manifestations of the disease. We report a case of a patient undergoing 4 level spinal fixation with coexistent myasthenia gravis (according to Osserman II B), requiring general anesthesia for spinal surgery in prone position. Myasthenia gravis affects the neuromuscular junction that is why it has a great significance of interest for the anesthetist
Knowledge, Attitude and Practices of First Aid among Non-medical Students of Karachi University
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An Unusual Presentation of Recurrent Hurthle Cell Carcinoma of Thyroid
Get PDFThis is the case of 55 years old male who was known of hurthle cell carcinoma (HCC) and underwent total thyroidectomy and right neck dissection in July 2015, followed by radioactive iodine (RAI). He was in close follow-up after the treatment when he presented with right sided neck swelling for 6 weeks followed by hoarseness for 4 weeks and fiber optic laryngoscopy revealed right vocal cod palsy. CT scan was done that showed a mass involving right supraglottic and glottis region, he then underwent right vertical partial laryngectomy. Tumor removed completely (grossly and histopathologically). The case was discussed in tumor board meeting and he was advised RAI scan to look for residual disease, by close follow-up. This case report emphasizes on the unusual clinical presentation and recurrence of HCC of thyroid
Recurrent Unresectable Aggressive Fibromatosis of Neck
Get PDFAggressive fibromatosis or desmoid tumors are classified as low grade, locally aggressive sarcomas with high propensity to recur and are lacking a clear census on management of recurrent-surgically in excisable tumors. We report here the case of a 27yrs old male with aggressive fibromatosis that recurred following a surgical excision, and resulted in hampering the quality of life. The disease was managed using cytotoxic chemotherapy with doxorubicin, resulting in significant clinical and radiological response. It was followed by maintenance regimen using a less aggressive approach with non-steroidal anti-inflammatory drugs such as celecoxib that resulted in further clinical response at 2 months follow up. Therefore, the therapy was further continued
Somatization: A Riddle Wrapped Up in an Enigma
Get PDFA propensity to experience psychological distress and their expression in the form of somatic symptoms and to seek medical help for them is called Somatization. It is basically an inception of some psychiatric conditions like Affective Disorders (anxiety and depression) and Somatoform Disorders. A Somatoform Disorder is a category of mental disorder in which physical symptoms that suggest physical condition or injury cannot be explained fully by a general medical condition. This possibility must always be considered when patient has recurring somatic complaints for at least six months. Depression and Somatic Symptoms Disorder can easily be recognized when they present separately or in association with each other. But the main hurdle is to develop a holistic approach and strategy to not be misguided by the intimidating nature of presenting physical symptoms. For that detailed evaluation should be carried out and every single possibility along with somatization should be kept under consideration, which would enable to recognize and treat the illness earlier and save considerable amount of time and resources as well
Cardiac Manifestation of the Patients with Novel Wuhan Coronavirus Infection: A Clinical Summary on Patients in the First Month of Outbreak
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Diagnostic Accuracy of Pre-operative Magnetic Resonance Imaging in Assessing Prognostic Pathological Parameters in Endometrial Carcinoma
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Long-term Outcomes of Pregnancy-Associated Breast Cancer: A Single Institution Experience
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Improving Cancer Patients Satisfaction with Treatment Process: A Pilot Interventional Approach in a Tertiary Care Hospital in Karachi, Pakistan
Get PDFChemotherapy is one of the treatments of choice worldwide to combat cancer. The complex nature of chemotherapeutic agents results in multiple physiological and psychological issues and if the patient and their caregivers (family) are unaware of these effects, poses additional stress which may result in patient dissatisfaction. This pilot project aimed to provide patients'/families' awareness regarding the process of treatment and subsequently to improve their satisfaction level