Spindle cell sarcoma presenting as pancoast syndrome

This report describes a patient who presented with pancoast syndrome, secondary to spindle cell sarcoma of the lung

A 56-year man presented with dyspnea, engorged neck veins and bilateral upper limb pitting edema

The patient also had ptosis and miosis in the right eye. Right ulnar nerve palsy with atrophy of hand muscles was seen. His chest X-ray showed bilateral pleural effusion with an opacity involving the apex of the right lung along with mediastinal widening

Echocardiography revealed a pericardial effusion which was drained

The patient's CT scan of chest strongly suspected a malignant mass in right upper lobe with extensive mediastinal lymphadenopathy, pleural metastases and pericardial involvement. He was started on oxygen inhalation, dexamethasone, and clopidogrel. Bronchoscopic biopsy confirmed the diagnosis of spindle cell sarcoma

Meanwhile, he was advised radiotherapy. The tumour was not amenable to surgery. Spindle cell sarcoma is a rare connective tissue tumor that replicates rapidly. To the best of the authors' knowledge, it is hereby reported the first case of spindle cell sarcoma of the lung presenting as Pancoast syndrome

Correlation between glycosylated hemoglobin and platelet activity among patients with type 2 diabetes mellitus

To determine the correlation between glycosylated hemoglobin level and platelet activity among patients with type 2 diabestes mellitus [T2DM]. This study was conducted in the Department of Medicine, Khyber Teaching Hospital, Peshawar from January to June 2012. Through a Comparative Cross Sectional Study Design, a total of 80 patients with T2DM were selected from Medical Wards and OPDs and were grouped into those with glycated hemoglobin [HbA1c] levels < 7% [Group A, n=33] and those with HbA1c >/= 7% [Group B, n=47 patients]. Both the groups were compared with regards to MPV and HbA1c. The mean age of patients was 47.41 +/- 6.74 years. In group A there were 45.5% [15] males and 54.5% [18] females. In group B there were 48.9% [23] males and 51.1% [24] female patients. MPV was significantly higher in group B as compared to group A [9.21 +/- 0.76 fl vs. 8.29 +/- 0.46 fl; P < 0.001]. Among the group B patients, a positive statistical Pearson's correlation was seen between MPV and HbA1c levels [r = 0.589; p < 0.001]. However, no statistical correlation was seen between MPV and the duration of DM and BMI. There is a significant association between poor glycemic control and increased platelet activity in patients with uncontrolled T2DM

effect of quinine on qt interval in patients in a tertiary care hospital

To determine the frequency of patients developing QT prolongation with the use of intravenous[IV] quinine therapy in medical unit D of Khyber Teaching Hospital, Peshawar. This cross-sectional study was conducted in Medical unit D of Khyber Teaching Hospital, Peshawar, from 1[st] June, 2011 to 30[th] November, 2011. The study population comprised of male and female patients who tested positive for malarial parasite on peripheral blood smear. Treatment was started with intravenous quinine for a minimum duration of 3 days to a maximum duration of 5 days. Electrocardiography [ECG] was done before starting the patients on IV quinine therapy and QT interval was calculated. Repeat ECG was done 72 hours after starting the therapy. Patients were evaluated for prolongation of the QT interval after initiation of treatment with quinine. All the statistical analyses were done using statistical program SPSS version 17.0. The mean with standard deviation, frequency and percentages were reported. Significance was tested at p<0.05. Out of a total of 200 patients, only 2 female patients [1%] had a prolongation of the QT interval from their normal baseline interval before treatment. It appears that the cardio toxic effects of quinine have been overstated and that the risk of QT prolongation and fatal arrhythmias is minimal with quinine therapy. It can thus be concluded that quinine is a safe drug for the treatment of malaria with negligible cardio toxic adverse effect profile

Guillain-barre syndrome in association with hepatitis a infection and nephritic syndrome

A 17-year-old male developed Guillain-Barre Syndrome [GBS] in association with acute hepatitis A infection followed by nephritic syndrome. Some cases of GBS were reported in association with acute hepatitis or nephrotic syndrome. GBS in association with nephritic syndrome alone or simultaneous nephritic syndrome and hepatitis A infection has never been reported