Bilateral renal lymphangiectasia with ascites and pleural effusion

A 42 year male patient with complaints of dull abdominal pain and hematuria for 01 year was referred by Nephrologist for abdominal ultrasound [USG]

USG demonstrated echogenic kidneys, perinephric and renal sinus cystic fluid collections bilaterally with minimal ascites and mild right sided pleural effusion. The USG findings were confirmed by computed tomography [CT] and magnetic resonance imaging [MRI] scan and were characteristic of renal lymphangiectasia. Awareness regarding renal lymphangiectasia will result in early diagnosis and management and decreased morbidity

Morphology of grafted tendon comparative study of first stage silicone rubber rod implantation

This is the first research done to explore the morphologic changes in two stage tendon grafting as compared to one stage tendon grafting. To compare morphology of grafted tendons with and with out first stage silicon rubber rod implantation. Comparative experimental study. 1994-2007. 30 patients were included in this study. They was divided into 3 groups. Group 1 underwent 2 stage tendon grafting group 3 was used as control morphological study of tendons. Group 1 [1-stage] tendon grafting showed degeneration and fibrous reaction as morphological changes. Group 2. [2 Stage] appeared as normal tendons morphologically. This study concludes that instead of direct tendon grafting, two stage tendon grafting is recommended

Early complications of laparoscopic cholecystectomy for calculous cholecystitis

Gallstones are the most common cause of hospitalization and most common elective procedure being carried out in hospitals. Although laparoscopic cholecystectomy is not as popular in Pakistan as in the west, because people have misconception of its complications. Therefore the present study was conducted to assess the early complications of laparoscopic cholecystectomy for calculus cholecystitis. This study was conducted at CMH Rawalpindi from January 2003 to July 2003. A total 100 patients with calculus disease were admitted. This comprised of 88 [88%] females, 12 [12%] males, age ranges from 21 to 60 yrs with mean age of 45 yrs. Patients were assessed per-operatively and post-operatively followed at 01 week, 01 month and 03 months for complications. The overall incidence of complications was 12% with major complication seen in only 4% cases. There was no mortality in our series. It is concluded that Laparoscopic cholecystectomy is safe with less post-operative morbidity and mortality

Brain Abscess in children

To find out the clinical presentation, radiological characteristics, various underlying predisposing conditions and causative organisms of brain abscess in children in our setup. Descriptive study. The Children's Hospital and the Institute of Child Health, Lahore, over two years from September 2001 to August 2003. All children [<16 years] presenting with brain abscess were included to study demographic, clinical and radiological features. In addition, attempts were made to find out underlying predisposing conditions and causative organisms. Twenty-five children with brain abscess were managed over 2 years. The mean age was 7.8 years [range 9 months to 16 years]. Male to female ratio was 2.1:1. Most patients [43%] presented with 4 weeks history of illness, with mean duration of illness at presentation of 29.3 days. Main presenting complaints were fever [72%], vomiting [48%], headache [44%] and convulsions [32%]. Five patients [20%] had papilledema at presentation, another 4 [16%] had paresis/paralysis and 3 [12%] had cranial nerve palsies. Majority [64%] had solitary abscess, located in parietal, temporal, frontal and occipital lobes in order of frequency. No underlying predisposing condition was identified in 8 [32%] cases; while 8 [32%] had cyanotic congenital heart disease, 5 [20%] patients had otic infection [mastoiditis], 2 [8%] were postoperative cases and one each developed brain abscess secondary to ventriculo-peritoneal [VP] shunt infection and pulmonary tuberculosis. Causative organisms were isolated in 40% cases, which included Staphylococcus aureus, Staphylococcus epidermidis, Streptococcal species, Klebsiella, E.coli and Proteus. Awareness of predisposing factors, early recognition of clinical features and understanding of the prevalent microbial profile is imperative for better management of children with brain abscess