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2012| July-September | Volume 2 | Issue 3
Online since
October 12, 2012
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EDITORIAL
Health care in Syria before and during the crisis
Mazen Kherallah, Tayeb Alahfez, Zaher Sahloul, Khaldoun Dia Eddin, Ghyath Jamil
July-September 2012, 2(3):51-53
DOI
:10.4103/2231-0770.102275
PMID
:23826546
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34
9,699
1,235
REVIEW ARTICLES
Atrial fibrillation post cardiac bypass surgery
Ashraf Mostafa, Mohamed A EL-Haddad, Maithili Shenoy, Tushar Tuliani
July-September 2012, 2(3):65-70
DOI
:10.4103/2231-0770.102280
PMID
:23826549
Atrial fibrillation occurs in 5-40% patients after coronary artery bypass graft surgery. Atrial fibrillation increases mortality and morbidity in the post-operative period. We sought to conduct a comprehensive review of literature focusing on pathophysiology, risk factors, prevention and treatment of post coronary artery bypass graft atrial fibrillation.
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917
CASE REPORTS
Trastuzumab for Her2/neu-positive metastatic salivary gland carcinoma: Case report and review of the literature
Belal Firwana, Bassel Atassi, Rim Hasan, Nour Hasan, Ammar Sukari
July-September 2012, 2(3):71-73
DOI
:10.4103/2231-0770.102282
PMID
:23826550
Salivary gland carcinomas metastasize to distant organs in 20% of salivary gland malignancies. Applying immunohistochemistry (IHC) measures, salivary gland tumors showed a wide range of oncogene markers expression, including the human epidermoid receptor 2 (Her2/neu), which could be targeted with monoclonal antibody. Treating salivary gland tumors, which have Her2/neu over-expression, with trastuzumab was reported in a few case reports. We report a 61-year-old Caucasian male, with a history of salivary gland tumor, who presented after 20 years of complete surgical resection with kidney mass. He was treated as primary renal cell carcinoma, unclassified, with nephrectomy and adjuvant clinical trail where he received placebo. Subsequently, he developed multiple hepatic lesions and retroperitoneal mesenteric lymphadenopathy; CT-guided biopsy revealed adenocarcinoma with Her2/neu, 3+ by IHC. The patient was treated successfully with trastuzumab with near-complete response.
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Myxoinflammatory fibroblastic sarcoma of the thigh: A morphologic diversity
Vanisri H Raghavan, Suchitha Satish, Sunila Ravishankar, Gubbanna V Manjunath
July-September 2012, 2(3):74-76
DOI
:10.4103/2231-0770.102283
PMID
:23826551
Myxoinflammatory fibroblastic sarcoma (MIFS)/acralmyxoinflammatory fibroblastic sarcoma (AMFS) is a rare, painless, low-grade neoplasm which commonly occurs in the extremities. It has a distinctive morphology and can be a diagnostic challenge, simulating inflammatory conditions as well as neoplastic conditions. They are low-grade sarcomas with a protracted clinical course, a high rate of local recurrence and a low rate of metastasis. We report a case of proximal MIFS in a 50-year-old woman who presented with a mass in the thigh.
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LETTER TO THE EDITOR
Hepatitis A vaccination in developing countries: Is Syria next?
Ghaith Habboub, Shadi M Alhalabi, Ghaith Mousabasha, Zaid AL-Faham
July-September 2012, 2(3):77-78
DOI
:10.4103/2231-0770.102284
PMID
:23826552
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ORIGINAL ARTICLE
Scintigraphic assessment of patellar vascularity in total knee replacement surgeries following lateral release
Padma Subramanyam, P Shanmuga Sundaram, Narasimha Rao
July-September 2012, 2(3):54-59
DOI
:10.4103/2231-0770.102277
PMID
:23826547
For a total knee replacement (TKR) to function well, the patella must track centrally in the trochlear groove. Lateral retinacular release (LR) is performed as an integral step in TKR to avoid maltracking. Patellar resurfacing and infra patellar fat pad excision are other small surgical procedures performed during TKR that can also easily deprive the patella of its vascularity. A three phase bone scan helps in the assessment of patellar vascularity. Literature review reveals a variable association (10-56%) of LR and patellar hypovascularity in Caucasians.
Objective:
LR release done in TKR is known to compromise patellar viability, while its extent and severity is still debated. Our prospective study was undertaken to evaluate the effects of LR on patella along with other variables like patellar resurfacement, fat pad excision, patelloplasty on knees by
99m
Technetium labeled methylene diphosphonate (
99m
Tc MDP) three phase bone scintigraphy (TBS).
Materials and Methods:
45 TKRs were done between Jan 05 and Jan 06. Of them, 15 patients (21 knees) of primary TKR were considered prospectively. Patients undergoing uni/bilateral TKR due to symptomatic knee osteoarthritis were only selected for this study. Pre- and immediate postoperative TBS was done with modified positioning of knee joints (adducted, externally rotated and flexed to 30°) to visualize patellae away from knee joint, which otherwise gets superimposed on the femoral condyles. A follow-up TBS at 8-10 weeks was done in patients showing immediate post-op patellar hypovascularity.
Results:
12/21 knees (57%) needed LR. Of these 12 knees, 8 (66%) showed hypovascularity; whereas 9 knees with no LR, 1 knee showed hypovascularity. All 9 knees (8 post LR+1 without LR) with hypovascularity underwent TBS again at 8-10 weeks and were found to show improvement in their vascularity status in all cases.
Conclusion:
Our study showed a higher incidence of LR in our population (57%). Association of LR and patellar ischemia was significant, about 16 times the risk. MDP bone scintigraphy is the only objective tool to quantify patellar vascularity. Overall 42.8% knees post-TKR had a transient patellar ischemia, and 38% of them were following LR. All of them recovered at 8-10 weeks postoperatively.
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REVIEW ARTICLES
Membranous nephropathy: Treatment outline and risk stratification
Ziad Arabi
July-September 2012, 2(3):60-64
DOI
:10.4103/2231-0770.102278
PMID
:23826548
Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adult. However, the exact etiology and the best treatment approach are still unclear. It is imperative to understand the nature of and prognosis of MN before initiating treatment which may include disease specific therapy based on a careful risk-stratification approach.
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© Avicenna Journal of Medicine | Published by Wolters Kluwer -
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Online since 05 February, 2011