Transjugular Intrahepatic Portosystemic Shunt (TIPS) in Refractory Transudative Chylothorax due to Liver Cirrhosis.

Chylothorax is an infrequent type of pleural effusion, typically exudative, caused by obstruction or laceration of the thoracic duct by malignancy, trauma, or thoracic surgery. Transudative chylous pleural effusions are extremely rare. We report a case of a 63-year-old male with recurrent transudative chylothorax secondary to cirrhosis that completely resolved with transjugular intrahepatic portosystemic shunting (TIPS).

Eosinophilic esophagitis presenting with spontaneous esophageal rupture: a case report.

Background: Eosinophilic esophagitis, once considered a rare disorder, has been increasingly recognized as a leading cause of dysphagia and food impaction in children and adults over the last few decades. It predominantly occurs in young men with a history of atopy. Dysphagia and food impaction are the most common presentations.

Cerebral Phaeohyphomycosis Complicated by Pulmonary Nocardiosis: A Tale of Two Infections.

, a melanized neurotropic fungus, is the most commonly reported agent of cerebral phaeohyphomycosis. We present a case of cerebral phaeohyphomycosis due to with a concomitant infection in the lung. The patient was a 64-year-old male who presented with one-week history of productive cough, confusion, and staggering gait.

A Rare Case of Cyclical Hemothorax: Thoracic Endometriosis Syndrome.

Endometriosis is a common condition in which endometrial cells and stroma are deposited in extrauterine sites. Its prevalence has been estimated to be 10% of reproductive age females. It is commonly found in the pelvis; however, it may be found in the abdomen, thorax, brain, or skin.

Cerebral air embolism from a Central Venous Catheter: A timely reminder of the importance of rapid diagnosis.

Cerebral air embolism (CAE) is a rare, avoidable and potentially fatal iatrogenic complication. Here, we report a case of CAE associated with a central venous catheter in the internal jugular vein that resulted in neurological deficits and generalised epileptic seizures. A 64-year-old man admitted for fasciotomy for compartment syndrome developed CAE with left-sided neurological deficits.

Immunosuppression with Antitumour Necrosis Factor Therapy Leading to Hyperinfection Syndrome.

is an endemic parasitic infection that can remain asymptomatic for years, but it can cause death in immunosuppressed individuals. Here, we present a case of hyperinfection in a 75-year-old male secondary to sepsis and chronic immunosuppression due to TNF- inhibitors. Despite aggressive treatment including broad-spectrum antibiotics and antihelminths, his respiratory failure worsened and he died after palliative extubation.

Varicella zoster meningitis: an atypical case of zoster reactivation in immunocompetent young adult.

Varicella virus is a neurotropic virus that can reactivate later in life to cause zoster or shingles. Typically, it affects elderly, immunocompromised population. We report an unusual case of an immunocompetent young adult presenting with occipital headache and zoster rash, without preherpetic and postherpetic neuralgia, who was diagnosed with varicella meningitis on Polymerase chain reaction (PCR).

Time intervals and associated factors of emergency treatment: first insight into Pakistani system.

The objective of this study is to determine the time interval from decision to seek medical help and arrival of the patients to the emergency department (ED). The duration of stay in ED was also calculated. This study also assesses factors responsible delayed presentation to hospital.

Virus against virus (VIVI): a potential solution against HIV/AIDS.

Most therapeutic regimens are aimed at the use of pharmacologic agents or the induction of immunological response against the pathological agent. However, these methods tend to be insufficient for the management of some of the most debilitating infectious diseases. Here we present a novel therapeutic approach.

Physicians reading and writing practices: a cross-sectional study from Civil Hospital, Karachi, Pakistan.

Background: To determine the behavior of physicians regarding medical literature reading and participation in research activities at one of the largest teaching hospitals in Pakistan.

Method: This descriptive, cross-sectional study was conducted by interviewing the house officers, residents and fellows of six major specialties (Medicine, Surgery, Pediatrics, Psychology, Obstetrics & Gynecology and Anesthesia) in Civil Hospital, Karachi between August and December, 2011. The questionnaire elicited responses regarding the reading habits of physicians, preferred sources of information, their participation in research activities (publication & supervision) and views regarding journal club.

Factors associated with duration of hospitalization and outcome in burns patients: a cross sectional study from Government Tertiary Care Hospital in Karachi, Pakistan.

Objective: Burns are important contributors toward mortality in trauma related injuries in Karachi, Pakistan. The aim of the present study was to delineate the factors contributing to the duration of hospitalization and mortality in such patients.

Methods: We performed a single center retrospective study of patients admitted during a 2 year period (January 2009 till December 2010) in Burns Center, Karachi.