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Introduction: Atrial fibrillation is common among patients withcardiovascular disease and is a frequent complication of theacute coronary syndrome.Objective: In this study our main goal is to assess theincidence of AF in patients of acute coronary syndrome.Method: This retrospective observational cohort study wasdone at Dhaka medical college and hospital from December2010 to December 2011 where 100 patients (male=73,female=27) were diagnosed with of ACS and AF. All data wereentered on the Statistical Package for Social Science (SPSS)and analyzed.Results: During the study most of the patients were belong to51-60 age group (53%) and 53% patients developed atrialfibrillation after admission. Also new onset AF patient’s hospitalstay rate was higher.Conclusion: After many analyses we can said that, incidenceof new-onset AF was more common in patients presenting withACS.
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The aim of this study was to assess the outcome of laparoscopic colorectal procedures performed in a district general hospital within 5 years period and to compare it with patients who had an open procedure during the same period. Data were collected retrospectively from patient's case notes retrieved from hospital medical records. One hundred consecutive cases of laparoscopic colonic resection including both benign and malignant diseases between 2005 and 2010 were analysed for perioperative and long term outcome and were compared with consecutive one hundred cases of open colectomies. Overall conversion rate was 6% for laparoscopic group. The mean major complication rates in laparoscopic group were 5% [3% in open group] and minor complications occurred in 18% [28% in open group]. There was no mortality in either group. The overall morbidity rate was 23% in laparoscopic group as compared to 31% in open colectomy group. In 64 cases, curative laparoscopic resections were performed for colorectal malignancy while 72 patients had resections for cancer in open group. The mean lymph node harvest in laparoscopic group was 13.2 nodes as compared to 12.4 in open group; no port-site recurrence was documented at a mean follow-up of 26 months. Average duration of surgery was 180 minutes as compared to 140 minutes in open group. Mean postoperative hospital stay was reduced from 13 days to 7 days. [Open Vs. Lap]. There was no statistically significant difference in major complication rates and mortality. Laparoscopic colorectal surgery is safe and feasible in elective colorectal cases and reduces the hospital stay without any added morbidity
Subject(s)
Humans , Male , Female , Laparoscopy , Retrospective Studies , Colectomy , Hospitals, GeneralABSTRACT
OBJECTIVE@#To assess the nutritional values and antioxidant analysis of 22 varieties of date palm (Phoenix dactylifera) fruit collected from various regions of the Sultanate of Oman.@*METHODS@#Nutritional parameters including moisture, fats, fiber, proteins, carbohydrates, and energy value were determined using standard methods of Association of Official Analytical Chemists. The antioxidant activity was screened for their free radical scavenging properties using ascorbic acid as a standard antioxidant. Free radical scavenging activity was evaluated using 1,1-diphenyl-2-picrylhydrazyl free radical.@*RESULTS@#The results of the date fruits (dried/tamar stage) revealed significantly higher moisture (15%-21%), dry matter (78%-86%), ash content (1.0%-2.0%), fiber (1.0%-2.5%), fat (0.1%-0.7%), protein (1.8%-3.8%), nitrogen (0.25%-0.55%), carbohydrates (74.5%-82.4%), and energy values (307-345.5 kcal/100 g). The antioxidant activity ranged between 40% and 86% depending upon the type of date and location. Overall, Khalas, Fardh and Khasab have significantly higher nutritional attributes; however, other varieties such as Barshi, Qush LuLu, Handal, and Khunaizi also have comparable nutritional values. The cluster analysis further evidenced the correlation of proximate parameters in different locations. Moreover, the nutritional and antioxidant attributes of similar date varieties collected from different locations were slightly varied.@*CONCLUSIONS@#The present finding helps in understanding the nutritional significance of different date varieties in Oman while the lesser known varieties can be improved through sustainable horticultural practices as a valuable product. The study further reveals that the consumption of these dates' fruits would exert several beneficial effects by virtue of their antioxidant activity.
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Objective: To assess the nutritional values and antioxidant analysis of 22 varieties of date palm (Phoenix dactylifera) fruit collected from various regions of the Sultanate of Oman. Methods: Nutritional parameters including moisture, fats, fiber, proteins, carbohydrates, and energy value were determined using standard methods of Association of Official Analytical Chemists. The antioxidant activity was screened for their free radical scavenging properties using ascorbic acid as a standard antioxidant. Free radical scavenging activity was evaluated using 1,1-diphenyl-2-picrylhydrazyl free radical. Results: The results of the date fruits (dried/tamar stage) revealed significantly higher moisture (15%-21%), dry matter (78%-86%), ash content (1.0%-2.0%), fiber (1.0%-2.5%), fat (0.1%-0.7%), protein (1.8%-3.8%), nitrogen (0.25%-0.55%), carbohydrates (74.5%-82.4%), and energy values (307-345.5 kcal/100 g). The antioxidant activity ranged between 40% and 86% depending upon the type of date and location. Overall, Khalas, Fardh and Khasab have significantly higher nutritional attributes; however, other varieties such as Barshi, Qush LuLu, Handal, and Khunaizi also have comparable nutritional values. The cluster analysis further evidenced the correlation of proximate parameters in different locations. Moreover, the nutritional and antioxidant attributes of similar date varieties collected from different locations were slightly varied. Conclusions: The present finding helps in understanding the nutritional significance of different date varieties in Oman while the lesser known varieties can be improved through sustainable horticultural practices as a valuable product. The study further reveals that the consumption of these dates' fruits would exert several beneficial effects by virtue of their antioxidant activity.
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Presented an extremely rare case of developmental Macroglassia in a female child with significant functional and cosmetic symptoms. The condition was worsening progressively despite persistent conservative treatment necessitating surgical management. Severe macroglassia is a rare condition, usually presents as an enlarged tongue causing not only the functional symptoms like airway, speech or dietary difficulties but also presents cosmetic and social issues. Such lesions are rare but well documented in the medical literature. Our case is a female patient who was asymptomatic by birth and thereafter, but started to have progressive increase in her tongue size at the age of two, with obstructive symptoms. The patient was initially treated by conservative therapy and other alternative minimally invasive modalities of treatment. After no significant improvement over a period of almost two years, the size kept on increasing and ultimately the massive size, the cosmetic and social stress necessitates the surgical option. The macroglossia was treated successfully by surgical excision relieving all the symptoms. Different aetiologies of the condition have been mentioned in the medical literature. The treatment depends on the diagnosis, the size, the location of the tongue involved and the symptoms caused by them. If the tongue is massively enlarged and the conservative treatment fails, the surgical excision is one of the best recommended treatment options
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To find out various modes of benign prostate hyperplasia [BPH] presentation in our region and their relation to postoperative failure to void after transurethral resection of prostate [TURP]. A study was conducted at Urology Department, Sandeman Teaching Hospital Quetta and Akram Hospital [Private] Quetta from January 2000 to December 2003. All BPH patients in whom the primary mode of presentation was accurately determined and later on underwent TURP were included in the study. Four modes of presentation were defined: [1] lower urinary tract symptoms [LUTS], [2] acute retention, [3] chronic retention and [4] and acute on chronic retention. After relevant investigations all these patients underwent TURP. Postoperatively catheter was removed when the urine was clear, usually within 48 hours of operation. Patients failing to void were recatheterized and given a second trial without catheter [TWOC] at third day of recatheterization. Resumption of spontaneous voiding on either the first or second TWOC was defined as "successful TWOC". Failure to void on second TWOC was defined as "failure to void" and was managed by a six week period of catheterization, followed by an additional TWOC. Statistical analysis was used to see any significant relation of failure to void postoperatively to mode of presentation of BPH, age of the patients and weight of the resected prostatic tissues. A total of 345 BPH patients were included in the study. Of these 270 [78.3%] patients presented with urinary retention and 75 [21.7%] with lower urinary tract symptoms [LUTS]. Patients who presented with retention were acute retention 129 [37.4%], chronic retention 81[23.5%] and acute on chronic retention 60 [17.4%]. The proportion of men failing to void after TURP was significantly higher [P <0.05] in those with [I] acute retention as compared to LUTS [ii] chronic retention compared to acute retention and [iii] acute on chronic retention as compared to acute retention. The proportion of men failing to void postoperatively was highly significant [P <0.005] in those with retention of any type as compared to LUTS. Age of the patients and weight of the resected prostatic tissues were found not significant factors in relation to failure to void postoperatively. BPH patients in our region present very late, most of them [>78%] with complication of urinary retention. Mode of presentation of BPH greatly influences the postoperative outcome of this disease. Patients presenting with complications of chronic and acute on chronic retention have less favourable results regarding postoperative voiding after TURP. Moreover age of the patient and weight of the prostate are not significant factors in relation to failure to void postoperatively
Subject(s)
Humans , Male , Prostatic Hyperplasia/surgery , Prostatic Hyperplasia/complications , Transurethral Resection of Prostate , Urinary Catheterization , Urinary RetentionABSTRACT
Objective: To present the efficacy and complications of vesicovaginal fistulae repair in our setting
Place and Duration of the Study: Surgical unit-III, Bolan Medical Complex Hospital, Akram Hospital Zarghoon Road, Quetta and Uhad Charity Hospital Quetta from April 1999 to March 2003
Patients and Methods: A total of 32 patients of vesicovaginal fistulae resulting from causes other than malignancies and pelvic radiations were included in the study. Patients were divided in to two groups on the basis of the site of the fistula and the method of repair. Group-I comprised of 18 patients who had type-II and low type-I fistulae and were operated by vaginal approach while group-II consisted of 14 patients who had type-III and high type-I fistulae and were operated by abdominal approach. Patients of both groups were discharged to go home after 5-7 days postoperatively. Postoperative follow up was carried out at out door on weekly basis for two months
Results: The cause of vesico-vaginal fistulae was obstetrical in 28 [87.5%] and gynaecological [hysterectomy] in 4 [12.5%] patients. Trans-vaginal repair of fistula was successful in 16 [88.9%] patients at first operation while in abdominal approach the cure rate was 100%. However preoperative bleeding requiring blood transfusion occurred in 5 [35.7%] patients of group-II. Another one patient in this group developed wound infection. Dysuria/urinary frequency and hematuria persisted for few days postoperatively in some patients of both groups. Urinary stress incontinence was present postoperatively in 5 [27.7%] and 3 [21.4%] patients of group-I and group-II respectively but it subsided in two months time in all except 2 [11.1%] patients of group-I
Conclusion: Birth trauma is still a major cause of vesicovaginal fistula in our region. Improvement in health services and socio-cultural status can help to reduce the incidence of this demoralizing injury. Once occurred VVF, can successfully be repaired by strictly adhering to principles of; a tension free repair, adequate blood supply, prevention of infection and adequate postoperative bladder drainage