The Cardiac Mirage: A Case of Ambiguous Chest Pain.

Background: Coronary artery disease (CAD) can masquerade as other illnesses due to its varied presentations, the co-existence of other chest pain etiologies, and the limitations of diagnostic modalities.

Case Report: We present a case of ambiguous chest pain due to multiple possible etiologies, including acute coronary syndrome (ACS), where initial cardiological testing yielded negative results. This led to a delay of 112 days in establishing the diagnosis and initiating appropriate treatment.

Effects of Gabapentin Enacarbil on Postoperative Pain After Hip and Knee Arthroplasty: A Placebo-controlled Randomized Trial.

Objectives: Total joint arthroplasties are among the most common elective procedures performed in the United States, and they are associated with postoperative pain. Gabapentin enacarbil is a prodrug with an extended-release formulation that has been proposed for multimodal postoperative analgesia, but the drug's efficacy for major arthroplasties remains unclear.

Materials And Methods: We enrolled 60 adult patients scheduled for primary knee or hip arthroplasty expected to remain hospitalized for at least 3 days.

Methylprednisolone Does Not Reduce Acute Postoperative Pain After Cardiac Surgery: Subanalysis of a Randomized Clinical Trial.

Background: Pain after cardiac surgery is largely treated with opioids, but their poor safety profile makes nonopioid medications attractive as part of multimodal pathways. Anti-inflammatory drugs reduce acute postoperative pain, but the role of steroids in reducing acute poststernotomy pain is unclear. We evaluated the association between the intraoperative administration of methylprednisolone and postoperative analgesia, defined as a composite of pain scores and opioid consumption, during the initial 24 hours after cardiac surgery.

Cerebral Venous Thrombosis After a Possible Inadvertent Dural Puncture for Labor Epidural Analgesia.

Pregnancy is a hypercoagulable state that increases the risk of thrombotic complications. A 32-year-old gravida 4 para 3 (G4P3) had a dural puncture during epidural catheter placement for labor analgesia. A positional headache started after delivery and continued for several days.

Superior Vena Cava Syndrome and Otorrhagia During Cardiac Surgery.

Otorrhagia during cardiac surgery is rare. Otorrhagia combined with other signs of increased venous pressure in the upper body indicates the development of superior vena cava (SVC) syndrome. In this case, ear bleeding, facial engorgement, and conjunctival edema were noticed.

A Case of Pseudo-pneumothorax with Complications.

Pseudo-pneumothorax occurs after inappropriately diagnosing a pneumothorax based on a chest X-ray. This can be attributed to skin folds, bed sheets, previous pneumothorax, heating blankets, clothes, and other circumstances that may mimic the radiographic findings of a pneumothorax. We present a case where a patient underwent a tube thoracostomy due to the diagnosis of a pneumothorax that was not, in fact, present.

A Case of Takotsubo Cardiomyopathy After Local Anesthetic and Epinephrine Infiltration.

Takotsubo cardiomyopathy (TC) is a non-ischemic cardiomyopathy that is accompanied by sudden left ventricular myocardial stunning, dilation and dysfunction. It often results from severe emotional or physical stress. We present the case of a 41-year-old female patient who had general anesthesia induced uneventfully for an elective bladder sling procedure.

Long Term Complications in Pediatric Liver Transplant Recipients: What Every Pediatrician Should Know.

The outcomes of liver transplantation in the pediatric population have improved significantly over the past two decades. As long-term survival improves, potential complications related to immunosuppression, delayed growth and development, and metabolic issues have started to be seen more commonly in long-term survivors. Hence, general pediatricians should to be aware of these potential complications in order to optimize the medical care and the quality of life for children with liver transplantation.

Colon Mass as a Secondary Metastasis from Cholangiocarcinoma: A Diagnostic and Therapeutic Dilemma.

Cholangiocarcinoma (bile ducts cancer) is a rare and aggressive form of cancer. It metastasizes frequently to liver, peritoneum, and lungs. Colon metastasis is extremely uncommon.

Gastrointestinal stromal tumor of colon: a case report and review of literature.

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal tract. GISTs originate from cells of Cajal and related stem cells. Surgery and imatinib therapy are the main lines of treatment.

A long-term profile of patients with irritable bowel syndrome.

Objective: To evaluate the symptom profile, course and prognosis of patients with irritable bowel syndrome (IBS) over a 15 years period.

Study Design: An observational study.

Place And Duration Of Study: Shifa International Hospital, Islamabad, Pakistan, from 1996 to 2011.