2020 VOL 5 , Issue 3

Editorial

Cord Compression from Bony Metastasis: An Important Quality of Life Issue which can be Resolved by a Spinal MDT Tumor Board

Sheikh Muhammad Ebad Ali, Badaruddin Sahito, Muhammad Amin Chinoy, Ahmed Nadeem Abbasi and Adil Khatri

Cancer prevalence is increasing over the past few decades. Spinal osseous metastasis is one of the most common sites of secondary neoplastic disease among cancer patients [1]. Spinal malignancies can broadly be classified into primary spinal cancers and secondary spinal metastasis. Metastatic spinal cancers are more common than primary malignancy of the spine. Metastatic spinal cancers are further subdivided into two parts based on the involvement of the dura mater; metastasis external to dura mater can be termed as metastatic epidural spinal cancers (MESC); metastasis inside the dura mater is called metastatic intradural spinal cancers (MISC) [2]. Bony involvements of vertebrae are common at the presentation of MESC while the involvement of the spinal cord and meninges is a prominent feature of MISC. However, the clinical presentation is quite overlapping and timely-decision making is quite challenging in several cases. Several grading systems have been developed to assess the severity of spinal cancers [3-6]. Such ambiguities require a need for teamwork between different specialties to decide the management plan for better patient care. Multidisciplinary Tumor Boards (MDT) are the practical venue where different specialists are present for the discussion [7].

Received: December 18, 2020
Revised: March 01, 2021
Accepted: March 03, 2021

doi.org/10.21089/njhs.53.0092

Research Articles

Obstructive Sleep Apnea in General Surgery Patients: Is Screening Required Preoperatively?

Osama Ahmed, Zahid Habib, Sheeraz Ur Rahman, Arshad Beg, Maira Shoaib, Asma Hirani and Abeer Hamidani

Abstract: Aim: To screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients.

Materials & Methods: It is a cross-sectional study. It was done in Liaquat National Hospital from January 2019 to June 2019. After institutional approval, 335 patients were included in this study, who presented to general surgery OPD. STOP-BANG questionnaire was used to screen cases who are at high risk and low risk for obstructive sleep apnea in general surgery patients.

Received: August 05, 2020
Revised: January 01, 2021
Accepted: January 06, 2021

doi.org/10.21089/njhs.53.0094

Substantiation of Multinational Association for Supportive Care in Cancer (MASCC) Score in Risk Assessment of Febrile Neutropenic Patients in Hematological Disorders: A Regional Study from Pakistan

Qurratul Ain Rizvi, Aisha Jamal, Naveena Fatima, Munira Borhany, Uzma Zaidi and Tahir Sultan Shamsi

Abstract: Background: The incidence of neutropenia in hematological malignancies comprises of huge burden of febrile neutropenia. Multinational Association of Supportive Care in Cancer (MASCC) risk index score is the most widely used model for forecast of complications.

Objective: The aim of this study was to determine diagnostic accuracy of MASCC scoring system in febrile neutropenia patients suffering from hematological disorders.

Materials & Methods: Patients suffering from hematological disorders and presenting with febrile neutropenia were stratified into low and high risk groups according to MASSC score. The standard score range from 0 to 26 points; score of more than or equals to 21 were considered to be low risk and score of less than 21 was high-risk category. As an in-patient at National Institute of Blood Disease & Bone Marrow Transplantation, they were followed over the course of illness for development of any serious medical condition until resolution of febrile neutropenia.

Received: November 30, 2020
Revised: February 17, 2021
Accepted: February 26, 2021

doi.org/10.21089/njhs.53.0099

Trend of Anti-SARS-COV-2 Seropositivity in Karachi

Nayab Afzal, Naila Tariq, Danish Shakeel and Sadia Sultan

Abstract: Objective: This study aims to determine the trend of seropositivity of anti-SARS-CoV-2 antibodies (total including IgM, Ig G) in patients presenting at a private hospital in Karachi.

Materials & Methods: A total of 2500 patients were included in the study. Informed consent was obtained and a questionnaire including patient’s age, gender, symptoms, history of traveling, contact with people who had travelled recently, contact with confirmed/suspected COVID-19 patient at home or work was filled. Samples were analyzed for anti-SARS-CoV-2 antibodies on Roche Cobase601.

Received: December 16, 2020
Revised: March 03, 2021
Accepted: March 03, 2021

doi.org/10.21089/njhs.53.0104

What do the White Spots in the Second Part of Duodenum Tell Us?

Ozge Kurtkulagi, Ozlem Yonem, Hatice Terzi, Engin Altinkaya and Ozgur Kurtkulagi

Abstract: Objective: The underlying conditions/diseases of scattered white spots in the duodenum are rather not very clear in the literature. We aimed to find out whether Helicobacter pylori, diabetes mellitus or inflammation has an impact on the presence of duodenal white spots.

Materials & Methods: We included all patients who underwent endoscopy between the time-period 2007-2017 in the Endoscopy Unit of Cumhuriyet University and had scattered white spots in the duodenum. Our control group was formed by randomly selected patients who underwent endoscopy at the same time period in whom duodenal biopsy was taken. The demographic data of both the patient and the control group, the presence of diabetes, endoscopic and histological diagnoses, neutrophil lymphocyte ratio, thrombocyte lymphocyte ratio, mean platelet volume and erythrocyte distribution width were obtained from the computer system of the hospital in detail.

Received: December 23, 2020
Revised: March 09, 2021
Accepted: March 10, 2021

doi.org/10.21089/njhs.53.0109

Research Articles

Internal Root Resorption : A Review

Syeda Asiya Butool, Nitin Kararia, Shyam Aggrawal, Rachit Mathur, Manas Bajpai and Ankit Sharma

Abstract: Internal resorption is an asymptomatic condition in teeth seen with past history of injury. In the crown it has a clinical observation of pink mark. It is diagnosed by chance on an x-ray examination. Primal detection and resorption treatment improves prognosis of the condition. Resorption can be broadly classified into normal physiological or pathological process associated with extensive damage to hard structures of tooth such as dentin, cementum and bone. Proper diagnosis of resorption and differentiation of resorption from internal and external resorption by radiographic presentation and the correct diagnosis and treatment planning improves the prognosis of the condition. Untreated cases will cause loss or early exfoliation of the afflicted tooth [1].

Received: June 11, 2020
Revised: December 29, 2020
Accepted: December 29, 2020

doi.org/10.21089/njhs.53.0114

A Bibliometric Analysis of Global COVID-19 Research

Shaheer Ahmed, Usama Waqar, Kantesh Kumar Lohana and Daniyal Ali Khan

Abstract: Background: Coronavirus disease 2019 (COVID-19) has influenced all continents, prompting extraordinary efforts on worldwide research and publications to alleviate the crisis.

Methods: We conducted a bibliometric review using Scopus to assess its impact on global scientific production. We searched for the following terms in titles, abstracts, and keywords to identify relevant literature published until 9th January 2021: 2019 novel coronavirus, 2019-nCoV, SARS-CoV-2, COVID-19, coronavirus disease-19, coronavirus disease 2019.

Received: November 30, 2020
Revised: January 14, 2021
Accepted: January 19, 2021

doi.org/10.21089/njhs.53.0119

Aldosterone: Implications in Diabetic Nephropathy

Fasiha Abdul Rehman, Zaid Abdul Razzak and Syed Saad Hussain

Abstract: Objective: The focus of this review is to summarize the recent advancement to understand the molecular pathogenesis of diabetic nephropathy (DN). Also, to highlight the role of abnormal aldosterone secretion on the development and progression of diabetic nephropathy.

Background: Diabetic Nephropathy (DN) is a progressive disease of nephron due to slow progressive failure of kidney tubule to perform its filtration process. It is often associated with proteinuria and glomerular stiffening which eventually leads to low glomerular filtration rate, finally succumbs the patient toward the end stage of kidney disease. The abnormal level of aldosterone in diabetes mellitus is a fatal combination to combat because of progressive development of diabetic nephropathy.

Methods: We reviewed the literatures for implications of aldosterone in diabetic nephropathy. The literatures that were related to different aspects of diabetic nephropathy in relation to aldosterone were analyzed and summarized in this review article.

Received: June 23, 2020
Revised: December 27, 2020
Accepted: December 28, 2020

doi.org/10.21089/njhs.53.0127

Case Reports

Oral Spindle Cell Carcinoma –Diagnosis Based on Immunohistochemical Interpretation

Syeda Asiya Butool, Ankit Natani, Betina Chandolia and Manas Bajpai

Abstract: Spindle Cell Carcinoma (SpCC) is a biphasic tumor. They are proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. It is a rare tumor which is infrequently observed in head, neck and in the aerodigestive tract. The tumor is aggressive and shows high frequency of recurrence and metastasis. It is an aggressive variant of squamous cell carcinoma which resembles a true sarcoma. It is a proliferation of spindle cells and squamous cells. For confirmation of diagnosis, immunohistochemistry is used. A Rare case of spindle cell squamous cell carcinoma in a 61 years old male in the tongue. The patient reported of rapidly growing lesion from six months with pain severe pain, dysphagia and difficulty in swallowing patient had history of chewing tobacco from past 35 years.

Received: July 17, 2020
Revised: November 30, 2020
Accepted: December 11, 2020

doi.org/10.21089/njhs.53.0133

Massive Proteinuria which Rapidly Resolved after Discontinuation of Regorafenib

Mehmet Zahid Kocak, Gulali Aktas, Satilmis Bilgin, Tuba Taslamacioglu Duman, Ozge Kurtkulagi, Burcin Meryem Atak, Irem Emir Ozcil and Haluk Savli

Abstract: Regorafenib is treatment option of cancers. It is associated with several adverse effects, including proteinuria. We report a massive proteinuria associated with regorafenib which resolved quickly after discontinuation of the drug. A 63 year old male presented with diarrhea and bilateral swallowing of legs. In urinanalysis, 18.5 g/day of proteinuria was detected. All symptoms, including proteinuria, resolved after discontinuation of regorafenib. Despite cessation of regorafenib treatment is advised in case of proteinuria, we suggest that regorafenib associated proteinuria could be rapidly resolved after discontinuation of the drug.

Received: November 16, 2020
Revised: December 12, 2020
Accepted: December 14, 2020

doi.org/10.21089/njhs.53.0136

Iatrogenic Venous Compression Syndrome due to Surgical Lumbar Hardware

Muhammad Akram Khan, Zahoor Khan and Abeera Azam

Abstract: Background: The Iliac vein compression syndrome (IVCS) is most commonly due to May-Thurner variant, an anatomic variant where in the right common iliac artery overlies the left common iliac vein and compresses it against the lumbar spine. The compression of the common venous outflow tract of the left lower extremity may cause discomfort, swelling, or deep vein thrombosis in the iliofemoral veins. The role of the pelvic surgery particularly the lumbar hardware in the development of symptomatic Venous compression syndrome in patients with May-Thurner syndrome is not well understood. The incidence is presumably very low. Herein, we present six patients who developed IVCS after Lumbar hardware.

Method: The cases were diagnosed between Nov. 2016 to Oct. 2019 in the Outpatient Cath Lab of McKinney, TX. The patient’s medical records were retrospectively analyzed looking for risk factors, clinical features, venogram findings, and post venogram. The evaluation of each case was described, and common trends were later presented in a cross-case analysis.

Received: April 06, 2020
Revised: December 18, 2020
Accepted: December 24, 2020

doi.org/10.21089/njhs.53.0140

2020 VOL 5 , Issue 3

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