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Diagnostic Dilemma of Intracardiac Mass: Tumor versus Thrombus-Case Series and Systematic Review
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作者 Indira Acharya ashik pokharel +1 位作者 Raktim Ghosh Christopher J. Haas 《Journal of Biosciences and Medicines》 2024年第7期141-150,共10页
Background: The differential diagnosis for intracavitary cardiac masses is limited, typically including vegetations, tumors, or thrombi. Cardiac thrombi can often mimic cardiac tumors on imaging, creating a diagnostic... Background: The differential diagnosis for intracavitary cardiac masses is limited, typically including vegetations, tumors, or thrombi. Cardiac thrombi can often mimic cardiac tumors on imaging, creating a diagnostic challenge. Primary cardiac tumors are rare and usually benign, whereas most cardiac tumors result from metastases, commonly originating from malignancies in the breast, lung, or melanoma. Aim: This report highlights the importance of distinguishing various cardiac masses based on clinical presentations, clinical courses, and radiological features. Case Presentation: We describe two cases of cardiac masses with unique and diverse clinical features. Each case posed significant diagnostic challenges due to their distinct presentations and clinical progressions. Conclusion: These cases underscore the importance of considering both benign and metastatic origins in the differential diagnosis of intracavitary cardiac masses. Accurate differentiation between thrombi and tumors is crucial for appropriate management and treatment. 展开更多
关键词 ECHOCARDIOGRAPHY Cardiac Masses ARRHYTHMIAS Cardiac Magnetic Resonance Imaging Cardiac Thrombi
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Chronic Refractory Idiopathic Urticaria
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作者 Indira Acharya ashik pokharel +1 位作者 Ashbina pokharel Lanaya Williams Smith 《Journal of Biosciences and Medicines》 2023年第11期13-22,共10页
Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, ... Background: Chronic spontaneous urticaria (CSU) is a complex medical condition characterized by substantial morbidity and a negative impact on one’s quality of life. There are several treatment approaches available, tailored to the severity of the condition, which can enhance overall quality of life. Aim: In this article, we outline a systematic approach to managing chronic urticaria, while also elucidating the available treatment strategies for cases that prove resistant to conventional therapies. To illustrate our points, we present a clinical case as a practical example. Case Presentation: Here, we present a patient with CSU since childhood who presented in the context of refractory hives and generalized arthralgia that responded well to omalizumab therapy with no further relapse. Conclusion: Omalizumab is a biological agent that offers a potential treatment option for CSU. It is available for individuals twelve years and older who have not responded well to conventional treatments. It has demonstrated good efficacy with a relatively low rate of clinically significant adverse effects. Nonetheless, there is a dearth of research regarding the optimal method for tapering the dosage and determining the duration of treatment. 展开更多
关键词 OMALIZUMAB Biological Agent Chronic Spontaneous Urticaria (CSU) Conventional Treatment RELAPSE
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Advanced Endoscopic Palliation of Unresectable Periampullary Carcinoma: A Systematic Review
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作者 Shailesh Simkhada Shravana Aryal +3 位作者 Albert D. Osei ashik pokharel Rami Matar Michael Maitar 《Open Journal of Gastroenterology》 CAS 2022年第10期249-262,共14页
Background and Aims: Periampullary malignancies often present at an advanced unresectable stage requiring palliation of symptoms for the better quality of life. Though they require multispecialty support;role of endos... Background and Aims: Periampullary malignancies often present at an advanced unresectable stage requiring palliation of symptoms for the better quality of life. Though they require multispecialty support;role of endoscopic interventions in palliation is paramount because of the advancement in technology and increase experience of Gastroenterologist. Methods: We did extensive review of articles regarding endoscopic advances in the management of Unresectable Periampullary Malignancies. Several systematic reviews, Meta analysis, and Randomized controlled trials published over the last 2 decades were thoroughly searched on PUBMED and GOOGLE SCHOLAR. Results: Advanced Endoscopic procedures have been emerging as a superior modality than conventional measures because of minimal invasiveness and greater clinical and technical success. Conclusion: Periampullary malignancies often present at an advanced unresectable stage requiring palliation of symptoms for the better quality of life. Several endoscopic interventions have already been established as the standard of care in palliation of symptoms of unresectable periampullary malignancies, we can say with confidence that with growing advances in EUS, advancement in technologies and increasing experiences, the role of gastroenterologist will be pivotal in these groups of patients. 展开更多
关键词 Periampullary Malignancies Endoscopic Ultrasound Celiac Plexus Neurolysis ERCP EUS-BD EUS-GE
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