Extra-corporeal shock wave lithotripsy; early experience with chinese lithotriptop at larkana

To evaluate the early Results of experience of ESWL to the effectiveness of Chinese lithotriptor. Period: From May 1999 to October 1999. Setting: Almas Medical Lithotripsy Center, Larkana. Fifty patients having renal and upper ureteric stones were treated with Chinese lithotriptor. Patients and The stone imaging and localization was done with the help of fluoroscope. The ages of the patients ranged from 10-52 years [average: 32 years]. 17[34%] were males and 33[66%] were females. Forty two patients had renal stones and 08 had upper ureteric stones. Simple analgesic and sedation was used before the procedure on 1st sitting. The over all stone free rate after 3 months of treatment was 78%. Five patients [10%] were dropped from the list because of failure of treatment. Remaining 6 patients [12%] showed partial fragmentation and residual stone in lower calyx. We noticed few transient complications including colic and haematuria which were managed easily. We conclude that the Chinese lithotriptor was as effective as other lithotriptors. It is also cost-effective

Clinco pathological experience of gall bladder cancer in northern Sindh

Carcinoma gall bladder has a poor prognosis despite surgical resection of the tumour

-3 A prospective study was planned to evaluate carcinoma gall bladder according to its Clinicopathological presentation. Its frequency among gall bladder diseases was 5.21 percent with male to female ratio 1: 1.22. Average and median ages were 53.43 years and 55 years respectively. Peak age group was 5th decade. Three most common presenting complaints were right hypochondria! Pain [67.24 percent], vomiting [34.48 percent] and lump right hypochondrium [27.58 percent]. Most common macroscopic appearance was cauliflower like mass. Gall stones were associated with 39.65 percent cases. Most of the tumours were adenocarcinomas, majority in advanced histological grades. Glandular pattern was noticed in 27 cases and papillary pattern in 21 cases. Compared to developed countries our patients were more than a decade younger

clinicopathological study of testicular cancer

Seventynine Cases of testicular tumour were studied at Chandka Medical College Hospital Larkana. Their ages ranged from 18 months to 60 years with an average age of 26 85 years Seminoma patients were older than those with non-seminomatous tumours. The peak age group was third decade of life. Two most common presenting complaints were testicular swelling and abdominal lump. The median time period between onset of symptoms and visit to physician was 6 months. The involved testis was undescended in 05[6.32 percent] cases. Inguinal and para aotic lymphadenopathy was present in 10 [12.65 percent] and 13 [16.45 percent] cases respectively. Metastasis to liver was present in 6.32 percent and to lung in 5.01 percent cases. Average diameter of testicular cancer was 7.94cm. Teratomas were largest and yolk sac tumours the smallest. The two most common histological variants were seminoma [56.98 percent] and embryonal carcinoma [17.72 percent]. When compared to the West, evidence of metastasis was more frequent in our patients. Median period between onset of symptoms and visit to physician was also longer in our patients

Pediatric solid cancer; a larkana experience

This prospective study was conducted to evaluate pattern and frequency of solid pediatric cancers of children in upper Sindh. Total number of cases was 214. Male to female ratio was 1.97:1 and mean age of patients was 8.7 years. Maximum number of patients were in 10-15 year age group [43.94%]. The five most frequent tumours were lymphoma [46.29%], soft tissue sarcoma [19.62%], retinoblastoma [11.68%], bone tumour [9.34%] and Wilm's tumour [7.0%]. CNS tumours were not represented in the study due to lack of neurosurgical facilities. Retinoblastoma and Wilm's tumour were more common in 0-4 year age group, whereas rest of the tumours were more frequent in 5-9 and 10-15 year age groups. Hodgkin's disease [62 cases] was more common than non-Hodgkin's lymphoma [37 cases], with higher male preponderance in the former [4.16:1] than in the latter [2.7:1]. Mixed cellularity was the largest subtype of HD [66.14%], whereas diffuse small cell [45.96%] dominated the NHL variants. We observed that HD was more common than NHL, and male to female ratio was higher in the former than in the latter in our study as compared to those reported from abroad. Further studies will confirm our findings

Transuretheral resection of prostate; Early experience in rural Sindh

Benign prostatic hyperplasia is common disorder affecting the men beyond middle age. Various modes of treatment e.g. watchful waiting, medical, conventional and endourological surgery are employed. Now a days various new minimal, invasive methods are getting popularity but TURP [Transuretheral Resection of Prostate] is still the gold standard method of treatment. From Oct 1994 to June 1998, Transuretheral Resection of Prostate [TURP] was performed in 100 patients to see the response rate and complications in our set up. Clinically all patients suffered from Benign Prostatic Hyperplasia and referred to us due to retention of urine and were already catheterized. Overall success response was seen in 96% of patients. Early and late complication rate observed was 23% and 13% respectively with 2% mortality rate. We concluded that TURP is the effective and safe endourological procedure with low morbidity

study of colorectal carcinoma

A total of 105 cases of colorectal carcinoma were studied over a period of five years from January 1993 to December 1997 at the histopathology section of Department of Pathology, Chandka Medical College [CMC], Larkana. Male to female ratio in the study was 2.08:1. Patient's ages ranged from 12 to 75 years, with mean age 44.63 years, which was higher in females [46.32 years] than in the males [43.83 years]. Most of the patients were in the 3rd to 5th decades of their lives [70.5 percent] with peak age in the 5th decade [26.7 percent]. More than 40 percent of patients were less than 40 years of age, including 04 [3.8 percent] teenagers, all males. Most of the tumours were located in the rectum, caecum and sigmoid colon in descending order of frequency. Left colon was more commonly involved than the right with male to female ratio higher in the former than in the latter. The most common histological type of carcinoma was adenocarcinoma diagnosed in 87 [82.87 percent], followed by mucinous variant in 15 [14.28 percent]. The most common presenting complaints were abdominal pain and bleeding per rectum. History of haemorrhoids was present in 07 [6.66 percent] and inguinal lymphadenopathy in 15 [14.28 percent]. Colorectal carcinoma in our study was, in many respects, similar to that reported from other parts of the country and abroad, though, our patients were much younger than their western counterparts

Pattern of colorectal carcinoma at Larkana

A total of 105 cases of colorectal carcinoma were studied, from January 1993 to December 1997 at the histopathology section of the Department of Pathology, Chandka Medical College, Larkhana. Male to female ratio in the study was 2.08:1. Ages of the patients ranged from 12 to 75 years with mean age of 44.63 years, which was higher in females [46.32 years] than in the males [43-83 years]. Most patients were seen between 3rd to 5th decade of life [70.5%] with peak age in the 5th decade [26.7%]. Most of the tumours were located in rectum, caecum and sigmoid colon in descending order of frequency. Left colon was more commonly involved than the right with male to female ratio higher in the former than in the latter. The most common histological type of carcinoma was adenocarcinoma diagnosed in 87 [82.87%] cases followed by mucinous variant in 15 [14.28%] cases. The most common presenting complaints of patients were abdominal pain and bleeding per rectum. History of haemorrhoids was present in 7 [6.66%] cases and inguinal lymphadenopathy in 15 [14.28%] cases. It was observed that colorectal carcinoma in the present study was in many respects similar to that reported from other pans of the country and from abroad but regarding the age, our patients were much younger than their western counter parts

Pattern of hepatocellular carcinoma in interior Sindh

To evaluate HCC according to its gross, histological and clinical presentation and its association with HbsAg. Prospective study. Department of pathology in collaboration with department of medicine and Larkana Institute of Nuclear medicine and Radiology [LINAR]. January 1993 to 1998. Total number of cases was 120. Male to female ratio of 2.6:1. Average age of patients was 52.16 years. Most commonly involved age group was fifth decade of life. Three fourths of tumours were of trabecular pattern. Most of the patients presented with hepatomegally, right hypochondrial pain and loss of weight. Right lode of liver was more frequently involved [67.5%] than the left [20%]. Both lobes were involved in 12.5% cases. Multifocal tumor was more common [65%] than the unifocal [35%]. All solitary tumors were larger than 5 cm in diameter. HBsAg was positive in 42.5% patients and 12.5% controls. Our patients were younger and their tumours were in more advanced stage at the time of diagnosis as compared to their western and far eastern counterparts