Adrenocortical oncocytoma

Adrenocortical oncocytoma is an exceedingly rare pathological variant of an adrenal neoplasm. The pathogenesis of oncocytic neoplasms is poorly understood. Females have been reported to be affected 2.5 times more frequently than males, and left-sided lesions are more common than those on right side. This case describes a 20 years old female with right lumbar pain. She found to have a right adrenal gland mass measuring about 6 x 5 cm. A computed tomogram showed hypodense mass lesion 6 x 4.2 cm involving right adrenal gland. Differential diagnosis of non-functional adrenal adenoma was made. A laparoscopic right adrenalectomy was performed using the 3-ports lateral transperitoneal approach. Histopathology showed adrenocortical oncocytoma of adrenal gland

Non alcoholic steatohepatitis: a concise review for clinicians

Non-alcoholic Steatohepatitis [NASH] is a common liver disease characterized by hepatomegaly, elevated serum aminotransferase levels, and a histological picture similar to alcoholic hepatitis in the absence of alcohol consumption sufficient to cause such changes. Most patients with NASH are obese women, and many have diabetes mellitus, hypercholesterolemia, or hypertriglyceridemia, but it also occurs in younger lean, otherwise healthy individuals. Most of the patients are asymptomatic, although some report fatigue, malaise or right upper quadrant discomfort. The most common sign of NASH is hepatomegaly. Laboratory abnormalities include a two to four fold elevation of serum aminotransferase levels; other liver function tests are usually normal. The pathogenesis of NASH is multifactorial. NASH should be considered in the differential diagnosis of patients with persistently elevated liver enzyme levels, particularly obese patients with diabetes and hyperlipidemia. The course of this disease is highly variable, but it may proceed to cirrhosis. Treatment of NASH is unproven, but weight reduction and altered life style are recommended

Perceptions on bioethics among patients presenting to family physicians at a teaching hospital in Karachi, Pakistan

To study the perceptions on bioethics among patients presenting to family physicians at a teaching hospital in Karachi, Pakistan Study design: Questionnaire based cross sectional survey Settings: The study was carried out at the family practice center, the Aga Khan University Hospital, Karachi Main outcome measures: Perceptions on the broad principles of bioethics Majority of the respondents were young and well educated and better placed socioeconomically. Respondents reported the moral duties of a physician and their reaction in the event of the death of a close relative due to a doctor's negligence. The majority agreed that a "doctor is next to god". Other issues studied include discontinuation of artificial life support, giving of gifts by pharmaceutical companies to doctors, sickness certification, organ donation, human cloning, disclosure of information to cancer patient and patient confidentiality. We have found interesting patient's perceptions on Bioethics with important implications for clinical practice

Perceptions on bioethics among general practitioners in Karachi, Pakistan

To study the perceptions on bioethics among general practitioners in Karachi, Pakistan. A questionnaire based cross sectional survey. 85 general practitioners in Karachi were surveyed at their clinic premises. Main outcome measures: Perceptions on the broad principles of bioethics. The majority of general practitioners were males, with mean age of 36.3 years, had minimal postgraduate qualifications and continuing medical education. They reported the top five moral duties of a physician and their reaction in the event of the death of a close relative due to a doctor's negligence. A significant number of respondents agreed that a 'doctor is next to God'. Other issues studied include discontinuation of artificial life support, giving of gifts by pharmaceutical companies to doctors, sickness certification, organ donation, human cloning, disclosure of information to cancer patient and patient confidentiality. We have documented the perceptions of general practitioners on broad principles of bioethics. These views have significant implications for medical practice