MyMedR

Managing Hot Flushes in Menopausal Women: A Review

Mallhi TH, Khan YH, Khan AH, Mahmood Q, Khalid SH, Saleem M

J Coll Physicians Surg Pak, 2018 Jun;28(6):460-465.

PMID: 29848424 DOI: 10.29271/jcpsp.2018.06.460

Hot flushes during menopause are distressing for women and result in poor quality of life. Purpose of the current review was to evaluate the available treatment modalities that should be utilised for the management of hot flushes. Menopause refers to last menses of women life and can be declared after amenorrhea of 12 months. Vasomotor symptoms including hot flushes and night sweats are common after menopause, affecting almost 50 - 85% women older than 45 years. The mean increment in core body and skin temperature is 0.5°C and 0.25 - 3°C during a hot flush attack. Low level of estrogen during menopause and its association in triggering episodes of hot flushes, is still under debate. The most accepted hypothesis is a narrowing of the thermoneutral zone (TNZ) triggered by estrogen fluctuations. Although, hormone replacement therapy (HRT) remains the standard treatment for the alleviation of such symptoms, incidence of life threatening side effects restrained medical professionals from its use. Complications associated with the use of HRT can be avoided by appropriate evaluation of patients before initiating therapy. Several guidelines have also recommended HRT (estrogen and progesterone) to be safe for up to a period of seven years. Both hormonal and non-hormonal treatments are used for the management of hot flushes. Since hot flushes are the least appreciated and neglected complication of menopause, current review provides detailed information on its background, pathophysiology and management, and emphasises the need of its treatment.

Prevalence of Chronic Kidney Disease in Asia: A Systematic Review of Population-Based Studies

Khan YH, Mallhi TH, Sarriff A, Khan AH, Tanveer N

J Coll Physicians Surg Pak, 2018 Dec;28(12):960-966.

PMID: 30501836 DOI: 10.29271/jcpsp.2018.12.960

Chronic kidney disease (CKD) is an asymptomatic disease associated with high morbidity and life-threatening complications that lead to decreased life expectancy. Worldwide prevalence of CKD is escalating at an alarming rate. Large population-based representative surveys have been reported in Western countries to estimate the prevalence of the disease. However, there is paucity of data as far as developing nations are concerned. Asia is the world's largest continent accommodating maximum number of under-developed and developing countries with an unclear picture of prevalence of CKD. Current review attempts to give an insight to the prevalence of CKD in this region by combining population-based surveys. This review will assist in estimating the burden of CKD in Asia, so that appropriate control measures could be designed.

Swelling on the Upper Lip: A Diagnostic Challenge

Tegginamani AS, Hs V, Wanjari SG, Dubey G

J Coll Physicians Surg Pak, 2019 Aug;29(8):796.

PMID: 31358112 DOI: 10.29271/jcpsp.2019.08.796

Clinical Audit of Urosepsis Treated in a Malaysian Surgery Unit

Lip HTC, Lip HTC, Lip HTC, Huei TJ, Huei TJ, Huei TJ, et al.

J Coll Physicians Surg Pak, 2019 Feb;29(2):185-186.

PMID: 30700363 DOI: 10.29271/jcpsp.2019.02.185

This is a retrospective audit of all patients admitted to the surgical unit for urosepsis from June 2014 to June 2015 at the General Surgery Unit of Hospital Sultan Ismail, Malaysia. Demographics, comorbidities, presenting symptoms, length of stay (LOS), mortality, and associated risk factors were recorded. There were 35 patients treated for urosepsis with a male preponderance of 21/35 patients. Hypertension (n=18) and diabetes (n=10) were the two most common comorbidities. There were five deaths (mortality rate=14.3%) and the main bacterium cultured was Escherichia coli. Age >65, presence of underlying comorbid disease, presence of cancer, urine and blood culture positivity had higher incidence of death but were not statistically significant for urosepsis mortality. However, this result is limited by the small sample size and single centre retrospective data.

Myocysticercosis of the Masseter Muscle

Nath S, Prajapati VK, Pulikkotil SJ

J Coll Physicians Surg Pak, 2019 Feb;29(2):196.

PMID: 30700369 DOI: 10.29271/jcpsp.2019.02.196

Multiple Small Bowel Atresia: Resection or Conservation?

Govindarajan KK, Annamalai M

J Coll Physicians Surg Pak, 2021 Jun;30(6):740-742.

PMID: 34102795 DOI: 10.29271/jcpsp.2021.06.740

Multiple small bowel atresia is a relatively uncommon cause of intestinal obstruction in neonates. About one-third of the neonatal intestinal obstruction is caused by intestinal atresia. As suggested by Louw and Barnard, the vascular accident in utero is the principal reason, resulting in bowel atresia.1 The condition presents soon after birth, with bilious vomiting and abdominal distension, requiring emergency surgical intervention. A subtype of small bowel atresia (type IV), which presents with involvement of multiple segments, is unique due to the difficulties in management, accompanied by a variety of postoperative morbidities, which are highlighted in this case. The choice lies between resection of all the atretic segments with resultant single anastomosis and conservation with anastomoses of multiple small bowel segments involving meticulous repair by fine sutures, taking care to maintain luminal patency. The dilemma of whether to conserve the atretic segments of bowel, which is a time consuming procedure but preserves the bowel length or to proceed with excision of the atretic bowel segments, accepting the likelihood of short bowel, in order to provide a quick, safe and stable single anastomosis in a timely manner, is a valid challenge. The background of limited resource setting also need to be taken into consideration. Key Words: Atresia, Neonates, Bowel segments, Anastomosis.

Adapting the New Normal Teaching Strategies as a Coping Mechanism for Dental Students

Veerabhadrappa SK, Yadav S

J Coll Physicians Surg Pak, 2021 May;30(5):608-609.

PMID: 34027882 DOI: 10.29271/jcpsp.2021.05.608

Null.

Temporomandibular Joint Disorders: Is there a Need for Additional Subspeciality in Dentistry?

Arshad S, Awang RA, Malik S

J Coll Physicians Surg Pak, 2021 Aug;31(8):1004.

PMID: 34320727 DOI: 10.29271/jcpsp.2021.08.1004

Null.

Managing Resistance to Change in Medical Education

Malik AS, Malik RH

J Coll Physicians Surg Pak, 2021 Oct;31(10):1141-1142.

PMID: 34601830 DOI: 10.29271/jcpsp.2021.10.1141

Null.

Mushroom Bezoar Causing Small Bowel Obstruction

Hamzah AA, Keow CK, Syazri A, Mallhi TH, Khan AH, Khan YH, et al.

J Coll Physicians Surg Pak, 2017 Mar;27(3):S13-S15.

PMID: 28302231 DOI: 238

A bezoar is a concretion of foreign or indigestible matter in the alimentary canal and is usual cause of gastric obstruction. Bezoars can become fragmented and migrate downward leading to intestinal obstruction. Diagnosis of phytobezoar has become challenging in clinical practice due to lack of patient history and inability of patient to correlate preceding events with the episode of bowel obstruction. Bezoar associated small bowel obstruction rarely occurs and is usually found in patients with history of gastrointestinal surgery. Very few cases are reported of small bowel obstruction due to bezoar in healthy population without prior illness or surgery. We present a case of small bowel obstruction due to mushroom bezoar in a 62-year patient with no past history of medical illness or gastric surgery. Enterotomy was performed and a whole piece of undigested mushroom measuring 5 x 3 cm was successfully removed.

Premolar Cystic Ameloblastoma in a Child

Pathak S, Sonalika WG, Hs V, Tegginammani AS

J Coll Physicians Surg Pak, 2017 Jan;27(1):47-48.

PMID: 28292369 DOI: 2521

Mandibular swellings may occur as a result of many benign lesions of odontogenic or non-odontogenic origin. Ameloblastomas are benign tumours of odontogenic origin, whose importance lies in its potential to grow into enormous size with resulting bone deformity, it is a slow-growing, persistent, and locally aggressive neoplasm. The unicystic ameloblastoma (UA) represents an ameloblastoma variant, presenting as a cyst clinically and radiographically, but showing typical ameloblastomatous epithelium lining histologically. It commonly occurs in second and third decades of life and is rare in children under 12 years of age, and better response to conservative treatment. It shares many clinical and radiographic features with odontogenic cysts/tumours and/or periapical disease of endodontic origin. Reported here is an unusual case of unicystic ameloblastoma involving the crown of an unerupted mandibular first premolar in a 9-year boy in an uncommon location, which was misdiagnosed as periapical lesion of inflammatory origin clinically, and as a dentigerous cyst radiographically. This highlights the importance to routinely submit the removed surgical specimen for histopathological examination.

The Probability of Resistant Hypertension During Dental Treatment of Chronic Kidney Disease Patients

Chidambaram R

J Coll Physicians Surg Pak, 2017 Jan;27(1):44-46.

PMID: 28292368 DOI: 2520

Oral rehabilitation in medically compromised patients like chronic kidney disease (CKD) needs special dental care. Many papers have been published on dental considerations for such individuals. However, literature citing oral care for patients with risk factors of CKD are scarce. Resistant hypertension, one such risk factor, is closely related to CKD. Furthermore, the associated increased prevalence and adverse renal/cardiac outcomes motivated the author to report its unexplored association/impact during dental care. The importance of assessing glomerular filtration rate is highlighted to better understand patients' medical conditions.

Cardiologist-Dentist Interaction in the Dental Management of Immunocompromised Cardiac Patient

Chidambaram R

J Coll Physicians Surg Pak, 2017 Apr;27(4):261.

PMID: 28492161 DOI: 2604

Multidisciplinary Approach for Management of a Patient with Oral Mucosal Malignant Melanoma

Eachempati P, Aggarwal H, Shenoy VK, Baliga M

J Coll Physicians Surg Pak, 2018 Sep;28(9):S187-S189.

PMID: 30173693 DOI: 10.29271/jcpsp.2018.09.S187

Oral mucosal melanoma is rare and more aggressive than cutaneous melanoma. Hard palate and maxillary alveolar crest are most commonly involved. Multidisciplinary team approach is necessary for successful management of this tumor. The main treatment modality is surgical resection, which usually results in impaired mastication, deglutition, speech, oral competence and significant cosmetic deformity. Here, a rare case of oral mucosal melanoma of mandibular gingiva in a 44-year man is reported, who was treated by en-block mandibular resection followed by adjuvant therapy with high dose interferons (IFN) - 2b. Following two weeks of healing period, prosthetic rehabilitation of the patient was done with an interim removable denture prosthesis, which effectively limited the unfavourable effects of surgery and helped him in resocialisation.

New Evidence Showing yet another Link between Sight-Threatening Diabetic Retinopathy and Obstructive Sleep Apnea: How Relevant is this to my General Practice?

Chidambaram R

J Coll Physicians Surg Pak, 2018 Nov;28(11):893.

PMID: 30369389 DOI: 10.29271/jcpsp.2018.11.893

A Single Institution's Experience with Cytogenetic and MRD Outcomes in Pediatric Acute Lymphoblastic Leukemia

Amjad A, Wali RM, Anjum S, Mansoor R

J Coll Physicians Surg Pak, 2019 Jun;29(6):549-552.

PMID: 31133155 DOI: 10.29271/jcpsp.2019.06.549

OBJECTIVE: To determine the frequency of cytogenetic type and its significance in the prognostic outcome of the pediatric patients in acute lymphoblastic leukemia (ALL), aged 1 to 15 years, and also determine the importance of minimal residual disease (MRD) in the management of the condition.

STUDY DESIGN: An observational study.

PLACE AND DURATION OF STUDY: Pediatric Oncology Ward, Shaukat Khanum Cancer Hospital, Lahore, from January 2015 to July 2017.

METHODOLOGY: Patients aged 1-15 years, diagnosed with ALL, were included. Studied variables were cytogenetic type and MRD outcome in patients with ALL. Patients under one year of age and more than 15 years, or those having comorbidities, were excluded.

RESULTS: Total 150 patients' data were retrieved from the Hospital database. One hundred and thirty-three belonged to age 1 to 5 years group (89%) and 17 (11%) were in 5 to 10 years group. The mean age of the patient was 4.3 +3.1 years. One hundred and two (68%) were males; whereas, 48 (32%) were females. Pre B acute lymphoblastic leukemia was diagnosed in 139 (93%) patients and 11(7%) were diagnosed with Pre T acute lymphoblastic leukemia. Standard risk was observed in 120 (80%) patients and 30 (20%) patients were on high risk as per National Cancer Institute (NCI) Guidelines. Regimen A was used in 125 (83.3%), Regimen B in 16 (10.7%), and Regimen C in 9 (6%) patients. BCR-ABL was positive in 2 (1.30%), TEL-AML in 68 (45%), MLL in 5 (3.30%), and normal in 54 (36%). MRD at day 29 was negative in 40 (93%) and positive in 3 (7%). The karyotyping was done in 128 (85%) patients, out of which 68 (53%) were hyperploids, 41 (32%) euploid, and 19 (15%) were hypoploid. Death was observed in 22 (15%) patients. Nineteen (86%) deaths were due to fungal and bacterial sepsis; and disease-related deaths were noted in 3 (14%) patients.

CONCLUSION: The role of MRD and cytogenetics in risk assessment has improved in the early prognosis determination.

Gingival Myiasis Affecting an Alzheimer Patient

Nath S, Pulikkotil SJ

J Coll Physicians Surg Pak, 2019 Mar;29(3):293.

PMID: 30823964 DOI: 10.29271/jcpsp.2019.03.293

Oxidizing Effect of Ozonated-Water on Microbial Balance in the Oral Ecosystem

Razak FA, Musa MY, Abusin HAM, Salleh NM

J Coll Physicians Surg Pak, 2019 Apr;29(4):387-389.

PMID: 30925969 DOI: 10.29271/jcpsp.2019.04.387

Application of ozone is recommended for sterilisation in dental procedures. This study explored the antimicrobial effect of 0.1 ppm ozonated-water on selected common oral commensals. Based on deviation of their growth curves pattern upon ozone treatment, the inhibitory effect of ozone was determined. SEM examination of the ozone-treated microbes recorded its possible morphological effect. Findings suggested a bacteriostatic action of ozone when microbes were treated at the early phase, while, it was bactericidal when treated during the active phase of the growth cycle. Hence, suggesting rinsing the oral cavity with ozonated-water at 0.1 ppm immediately after tooth brushing may suppress microbial growth and slow biofilm formation. While, rinsing on already developed biofilm may result in microbial cell lysis that halted microbial growth and reduce microbial population in the biofilm. Both justify the great potential of ozone (0.1 ppm) for use as antimicrobial agent for the control of biofilm development in the oral cavity.

Conventional versus Minimally Invasive Vein Harvesting: A Clinical Audit of Wound Dehiscence Complications

Shiang SW, Vendargon SJ, Hamid SRBGS

J Coll Physicians Surg Pak, 2019 Apr;29(4):371-374.

PMID: 30925964 DOI: 10.29271/jcpsp.2019.04.371

OBJECTIVE: To determine the wound complications post coronary artery bypass graft surgery (CABG) by conventional vein harvest technique (CVH) and minimally invasive vein harvest technique (MIVH) in Hospital Sultanah Aminah Johor Bahru, Malaysia.

STUDY DESIGN: Clinical audit report.

PLACE AND DURATION OF STUDY: Hospital Sultanah Aminah Johor Bahru, Malaysia, from March 2016 to May 2017.

METHODOLOGY: Data were collected retrospectively from all 127 patients who underwent CABG with saphenous vein grafts, either with CVH technique (n=68), or MIVH technique (n=59) performed with Vasoview system. The rate of wound dehiscence was evaluated. Patients with severe wound dehiscence that required readmission and surgical intervention were identified for further evaluation.

RESULTS: There was total 26.8% of wound dehiscence in our study, which was not appreciably different between two groups (p=0.092). Patient with severe wound breakdown that required surgical intervention was significantly less in MIVH group (1/59, 1.7%) compared to CVH group (8/68, 11.8%, p=0.037). There was no significant difference in readmission rate between MIVH and CVH group (p=0.574).

CONCLUSION: There is significant reduction in severity of wound dehiscence post-saphenous vein harvesting among CABG patients with MIVH technique. However, there is no statistical difference in wound dehiscence and readmission rate between MIVH and CVH technique.

Analysis of CD 133 Expression in Oral Leukoplakia

Tegginamani AS, Kallarakkal TG, Vanishree HS, Muttalib KBA

J Coll Physicians Surg Pak, 2019 Jul;29(7):688.

PMID: 31253228 DOI: 10.29271/jcpsp.2019.07.688

Displaying publications 21 - 40 of 52 in total