experience of open Anderson-Hynes pyeloplasty

To document the outcome of open Anderson-Hynes pyeloplasty for pelviureteric junction [PUJ] obstruction in terms of renal function and complications. Descriptive study. Department of Urology at Peoples University of Medical and Health Sciences for Women Hospital Shaheed Benazir Abad [Nawabshah] from 2007 to 2009. Thirty consecutive cases of pelviureteric junction obstruction were admitted. All patients underwent Anderson-Hynes open pyeloplasty. Complications and outcome were recorded. Most of our patients were male [n=25]. Majority belonged to age group 1-5 year [n=18]. Left side was affected in most of the cases [n=22]. Low incidence of postoperative accepted complications noted. Post operative outcome was excellent In relation to improved drainage and renal function. Anderson-Hynes pyeloplasty was safe, with low postoperative complication rate and better renal function preservation

Risk factors in various subtypes of ischemic stroke according to TOAST criteria

To identify the frequency of risk factors in various subtypes of acute ischemic stroke according to TOAST criteria. Cross-sectional, observational study. Ziauddin Hospital, Karachi, from January to December 2007. Ziauddin Hospital, Karachi, from January to December 2007. Patients with acute ischemic stroke were enrolled. Studied variables included demographic profile, history of risk factors, physical and neurological examination, and investigations relevant with the objectives of the study. Findings were described as frequency percentages. Proportions of risk factors against subtypes was compared using chi-square test with significance at p< 0.05. Out of the 100 patients with acute ischemic stroke, mean age at presentation was 63.5 years. Risk factor distribution was hypertension in 85%, Diabetes mellitus in 49%, ischemic heart disease in 30%, dyslipedemia in 22%, smoking in 9%, atrial fibrillation in 5%, and previous history of stroke in 29%. The various subtypes of acute ischemic stroke were lacunar infarct in 43%, large artery atherosclerosis in 31%, acridoembolic type 8%, stroke of other determined etiology in 1% and stroke of undetermined etiology in 18%. Hypertension and Diabetes were the most association was found with ischemic heart disease [p=0.01]. Importance and relevance of risk factors evaluated for subtypes rather than ischemic stroke as a whole should be reflected in preventive efforts against the burden of ischemic stroke

Colostomy in children: indications and complications

To determine the indication and frequency of complications occurring with construction of colostomy in children. This descriptive study was conducted at Paediatric Surgery department of PMC Hospital and at Mumtaz Medical Center [Pvt.] Nawab Shah, from April 2008 to December 2009. All patients who required colostomy as the part of management were included in this study. The patients who were operated upon previously or elsewhere and were referred after having colostomy, were excluded. In all patients loop colostomy was performed. Complications after colostomy construction were noted on a proforma. Thirty- seven colostomies were created in 36 patients. Sigmoid loop colostomies were 51.35%, Right and left transverse colostomies in 24.32% each. All patients were operated due to congenital anomalies. Twenty-eight patients had anorectal malformation and 8 Hirschsprung's disease. Common Complications related to stoma were excoriation of skin 58.82% and prolapse of stoma [50%]. Anaemia due to chronic blood loss was seen in 53.33% of patients. Transverse loop colostomy had higher number of complications / problems as compared with sigmoid loop colostomy. Five [13.88%] patients died [Three because of septicaemiae, one because of high grade fever at home, and one died on 2nd of PSARP, the cause could not be ascertained. Construction of colostomy in paediatric patients carries high frequency of complications and requires careful technique. A sigmoid loop colostomy is an ideal as it has minimal complications. Stoma care clinic and enterostomal therapist can be helpful in educating families for stoma care and to decrease the incidence of complications