The Combined Military Hospital Lahore is the largest tertiary care teaching hospital operated by the Pakistan Army. Its primary function is to provide specialized medical treatment to Armed forces personnel, their dependents (immediate families), as well as the general public. It is headed by a Brigadier from the Army Medical Corps of the Pakistan Army.
Cervical cystic hygroma, or lymphatic malformation, is a rare congenital anomaly that can present as a life-threatening airway emergency in neonates. Prompt recognition and timely management are critical for survival. While surgical excision has traditionally been the mainstay of treatment, extensive lesions involving vital neck structures carry significant operative risks in the neonatal period. We report a full-term neonate presenting at birth with a giant cervical cystic hygroma causing airway compression and respiratory distress. Due to high surgical risk, emergency ultrasound-guided intralesional bleomycin sclerotherapy was performed, resulting in a marked reduction in lesion size. At the six-month follow-up, there was no recurrence. This case underscores the role of image-guided intralesional sclerotherapy as a safe, effective, and minimally invasive life-saving alternative for neonates with giant cervical cystic hygroma.
BACKGROUND:Comorbidities increase the risk of adverse outcomes from infections. This study aimed to assess the prevalence and outcomes of vaccine-preventable infections (VPI) in adult congenital heart disease (ACHD) patients compared to the general population. METHODS:Using the 2016-2020 National Inpatient Sample database, we identified VPI hospitalizations and compared outcomes between ACHD patients and the general population. The primary study outcome was in-hospital mortality, with secondary outcomes including respiratory failure, acute kidney injury, acute liver failure, septic shock, cardiac arrest, length of stay, and total hospital charges. RESULTS:Of 647,440 patients hospitalized for VPI, 2610 (0.3%) had ACHD. After adjustment for baseline characteristics, ACHD patients had similar odds of in-hospital mortality (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 0.64-1.98), respiratory failure (aOR 1.05, 95% CI 0.84-1.32), septic shock (aOR 1.03, 95% CI 0.66-1.60), and cardiac arrest (aOR 1.01, 95% CI 0.36-2.74), but higher odds of acute kidney injury (aOR 1.34, 95% CI 1.09-1.67) and acute liver failure (aOR 1.27, CI 1.01-1.60) compared to the general population. CONCLUSION:ACHD patients hospitalized for VPI have similar in-hospital mortality, but higher acute kidney injury and liver failure rates compared to the general population, highlighting the importance of vaccination in this vulnerable patient group.
Background The zoonotic orthopoxvirus illness Monkeypox (Mpox) is re-emerging. While historically characterized by a particular course of symptoms, current outbreaks have revealed a range of clinical signs and symptoms, particularly in terms of the onset of lesions as well as systemic prodrome Objective To explain the clinical characteristics, particular dermatological progression patterns as well as results of 6 patients with PCR confirmed Mpox to help doctors in early identification. Methods This case series was conducted at Department of Dermatology, Combined Military Hospital (CMH) Lahore, where patients who tested positive for Mpox Virus by Polymerase Chain Reaction (PCR) presenting between December 1, 2025 and January 31, 2026, were incorporated in the study. The data collected as well as analyzed included demographics, traveling history, sexual history, prodromal symptoms as well as lesion morphology, primary site, progression and clinical resolution. Results Primary lesions appeared in the genital and supra - pubic areas of all 6 male patients (mean age 27.1 years) in crops. Only 33 % (n=2) experienced fever before rash onset, indicating atypical prodromes. Inguinal lymphadenopathy was associated in 100% of cases (n=6), which was noteworthy. Over an average of 9 days, the lesions progressed from papulovesicular to typical umbilicated pustules with central crusting. Within 2.8 to 4 weeks, full clinical resolution had been attained. Conclusion The present global outbreak of Mpox is characterized by a "genital-first" pattern and highly variable prodromal symptoms, as evidenced by this particular case series. The 100% presence of inguinal lymphadenopathy within our cohort is a crucial diagnostic indicator, particularly when conventional symptoms such as pre-rash fever are not present. Clinicians must maintain a low index of suspicion and a low threshold for PCR assessment when encountering localized genital crops, irrespective of traveling history or febrile condition of the patient.
INTRODUCTION:This review assesses whether the mode of solute clearance in continuous renal replacement therapy influences mortality and renal recovery. METHODS:The protocol was registered with PROSPERO (CRD420251030433). PubMed, Cochrane Library, and LILACS databases were searched until April 24, 2025. Observational studies and randomized controlled trials comparing diffusive and convective strategies of continuous renal replacement therapy in patients with acute kidney injury were included. Risk of bias was assessed using Cochrane ROB 2 and ROBINS-I tools. RESULTS:Thirteen studies with 1146 patients were included. Diffusive modality had no advantage over convective modality with regards to mortality in intensive care unit (RR = 1.04; 95% CI: 0.83, 1.30; p = 0.73), 28-day mortality (RR = 1.19, 95% CI: 0.89, 1.59; p = 0.25), renal recovery (RR = 1.07; 95% CI: 0.65, 1.75; p = 0.79), or the length of stay in intensive care unit (SMD = 0.16 days; 95% CI: -0.17, 0.49; p = 0.33). Filter clotting was 31% less frequent in diffusive modality (RR = 0.69; 95% CI: 0.58, 0.81; p < 0.001). CONCLUSION:Diffusive modalities of continuous renal replacement therapy are not different from convective modalities in terms of mortality and renal recovery. However, they have the advantage of a longer filter lifespan resulting from less frequent clotting.
Background and Objectives: Due to the associated impact on quality of life, chronic kidney disease leads to the development of depression. This study was done to assess the relationship between social frailty and depression in End-Stage Renal Disease patients. Materials and Methods: This study was conducted at the Combined Military Hospital Lahore, including patients aged> 13 years of either gender with ESRD. All patients were evaluated for depression using the Patient Health Questionnaire-9 and for frailty using the Social Frailty Index-7 questionnaire. The effect modifiers such as age, duration of dialysis, concern regarding serum creatinine, fear of disability, dialysis-associated fatigue, and haematological parameters were also assessed using binary logistic regression analysis. Results: A total of 150 patients with a mean age of 56.93 ± 13.78 years were enrolled. Among these, 106 (70.6%) were males, 61 (40.67%) had diabetes mellitus, 71 (47.33%) often felt fatigued, 103 (68.67%) had unintentional weight loss, and 59 (39.33%) reported slight concern about serum creatinine levels. Frailty and depression showed a significant correlation (r = -0.305, p<0.001). Similarly, socially frail patients had markedly higher odds of depression (adjusted OR 105.74, 95% CI 13.38–835.00; p < 0.001) compared with non-frail individuals. Associations observed for education, income, fear of disability or death, unintentional weight loss, polypharmacy, and serum albumin were no longer significant after adjustment for confounders; however, fatigue frequency and concerns about serum creatinine levels remained significant. Conclusions: Frailty, fatigue, and psychological concern about serum creatinine levels were independently associated with depression in ESRD patients
