Comparison of maternal serum lipoproteins in normal pregnancy and primiparous patients with eclampsia

Objective: To evaluate changes in serum lipoproteins in primiparous women with eclampsia and compare it with pregnant women having normal blood pressure

Methods: This cross sectional study was conducted on 65 primiparous eclamptic patients and 21 normotensive pregnant women in the tertiary care hospitals of Peshawar. History of each woman was recorded on a questionnaire. Blood pressure was measured using standard methods. About 5 ml of venous blood was drawn for the analysis of lipoproteins

The data was analyzed using computer software package SPSS version 10. The P value <0.05 was considered statistically significant

Results: Mean age of hypertensive cases was 23.2 +/- 0.52 years while that for controls was 23.9 +/- 1.16 years. Significant differences were found in serum lipoproteins. Women having eclampsia had 28.8%, 29.5%, 31.1%, 32.9% and 65.3% higher, low density lipoprotein-cholesterol [LDLC], triglycerides [TG], total cholesterol [TC]:high density lipoprotein-cholesterol [HDLC] ratio, LDLCiHDLC ratio and TG:HDLC ratio respectively as compared to the control group. The HDLC concentrations, HDLC:VLDLC ratio and apolipoprotein-A1 level were 26.9%, 56.6% and 27.9% respectively, lower in the patient group as compared to the controls

Conclusion: This study suggests that evaluation of lipoprotein concentrations during antenatal period can be helpful in the early detection and prevention of developing eclampsia

Outcome of intracorporeal cystolithotripsy in children

Objectives: To evaluate the success and complications of intracorporeal cystolithotripsy in children

Design: It was prospective and descriptive study

Place and duration of study: Study was conducted in Department of Urology Allied Hospital, [PMC] Faisalabad from January 2011 to December 2012

Patients and Methods: Total number of 40 patients with vesical stone

Results: Children with average age of 7.23 years were included in study. Stones were completely removed in [90%] patients. Perforation occurred in 2.5% patients, 5% patients required redo intracorporeal cystolithotripsy due to stone impaction in urethra. 2.5% Patients needed open vesicolithotomy due to bleeding

Conclusion: Intracorporeal cystolithotripsy with pneumatic lithoclast is a safe and valid procedure for management of vesical calculi in children

Vesicovaginal fistula, causative factors and outcome of surgical management: an experience at PMC/allied hospital Faisalabad

Objectives: To assess the causative factors and outcome of surgical management of Vesicovaginal fistula [VVF] in our set up

Duration and Design of Study: Retrospective descriptional study from January 2008 to June 2012 conducted at Department of Urology PMC/Allied Hospital Faisalabad

Methodology: All patients with VVF who presented in our out patient department and underwent surgical repair in our department were included in this study. The records of patients were reviewed and data was entered in a structured proforma and analyzed. After history, physical examination, relevant investigations, IVU, Cystoscopy and vaginoscopy, patients were divided into two groups. Patients with supratrigonal fistula were operated through abdominal approach and those with infratrigonal fistula were operated through vaginal approach. The outcome of surgical procedures and post operative complications were noted

Results: This study included 68 patients. In 42 [61.76%] patients, cause of VVF was iatrogenic injury during hysterectomy, and 26 [38.24%] patients developed VVF due to obstetric causes. Fifty patients [73.53%] had supratrigonal fistula and eighteen patients [26.47%] were having trigonal or subtrigonal fistula. We achieved 90% and 83.33% success rate with abdominal and vaginal repair respectively

Conclusion: The most common cause of VVF is iatrogenic injury during hysterectomy. Both approaches of surgical repair had almost equally good results

Outcome of anastomotic urethroplasty for stricture urethra

To evaluate the outcome of end-to-end urethroplasty for stricture urethra and need for ancillary procedures. Prospective, study was carried out in Department of Urology Allied Hospital Faisalabad from Oct, 2007 to April, 2010 to see the outcome for anastomotic urethroplasty in 40 patients. Simple perineal urethroplasty was done in 30 patients. Perineal urethroplasty with separation of corporal bodies was done in 06 patients and inferior pubectomy was required in 02 patients according to indication. Age, length of stricture and ancillary techniques required during reconstruction were combined. Success was considered when there was no need for redo anastmosis, IOU or patient was cured by dilatation. Out of 40 patients that underwent end-to-end urethroplasty, 35 [87.5%] were successful. Simple perineal urethroplasty showed a success rate of 93.75%. Perineal urethroplasty with separation of corporal bodies had a success rate of 66.66%. Patients in which inferior pubectomy was required had success rate of 50%. End-to-end urethroplasty is an excellent option for treatment of stricture urethra and majority of failures occurs in children and those having very proximal membranoprostatic urethral strictures

Arteriovenous fistula [AVF] formation: comparison of end-to-side and side-to-side techniques in end stage renal disease

To compare the success and complications of the side-to-side and end-to-side techniques of AV fistula formation. A prospective randomized comparative analysis of 344 cases. The study was carried out from February 2006 to July 2010 in the Department of Urology, Punjab Medical College and Al-Noor Hospital Faisalabad. A total number of 344 patients with end stage renal disease [ESRD] were included in the study for AV. fistula formation for hemodialysis access. 304 patients completed their follow up. AV fistula was made by end-to-side and side-to-side techniques. Patients were followed after 24 Hours, 1 week, 1 month and 6 months after the operation. These 304 patients were divided into 2 groups. Group 1 comprises of 154 patients and group 2 comprises of 150 patients. AV fistula worked successfully in 88.3%, 70.78%, 68.18% and 61.04% of 154 group 1 patients after 24 hours, one week, one month and six months followup respectively. AV fistula worked successfully in 76%, 65.33%, 63.33% and 58% of 150 group 2 patients after 24 hours, one followup respectively. Hemorrhage from fistula site was among 9.09%patients in group 1 and in 7.33% in group 2 patients after 24 hours of surgery while it was 2.6% and 1.33% patients in group 1 and group 2 patients respectively after one moth follow up. Aneurysm was seen in 1.3% patients at one month and six months follow up respectively in group 1. It was seen in 0.67 and 1.33% patients at one month and six months follow up in group 2 patients. Ischemia was seen among 1.3% patients in group 1 and 8% in group 2 patients. No limb edema was present up to 1 week in any group. Odema was in 9.74% and 13% patients of group 1 patients at one month and six months follow up and 14.67% and 17.33% of group 2 patients at one month and six months follow up respectively. Both operative techniques for AV fistula formation are equally good for hemodialysis access but complication rate with end-to-side technique is lower as compared to side-to-side technique

History of medicine. Ibn Nafis - a forgotten genius in the discovery of pulmonary blood circulation

Scientific theories take centuries to come into existence and they keep on evolving. Uncountable intellectual minds work on these theories; some fail to do anything about it; some add a little after tremendous efforts, and some people give remarkable and unforgettable contribution. As far as credit is concerned, the person who is able to prove the theory by his facts and who clears the maximum doubts by his observations, experimentations, facts and reasoning, gets the credit for that theory, and this should be done with honesty. The theory of pulmonary circulation took more than 2000 years to come into existence as we know it today. With the passage of time different people were given credit. Some say that it was given to Galen; some say it was Michael Servetus; others say that Realdus Columbus was the real discoverer; some gave the credit to Ibn Nafis, and finally people gave the credit to William Harvey. But after the rediscovery of Ibn Nafis' manuscript no.62243 titled Sharah al Tashreeh al Qanoon, or "Commentary on the anatomy of Canon of Avicenna" in 1924 AD in Europe, it became clear that Ibn Nafis had described the pulmonary circulation almost 300 years before Harvey, and the historians like Aldo Mieli, Max Mayrhoff, Edward Coppola etc. clearly state that Ibn Nafis is the real discoverer of the pulmonary circulation and that he should be given the credit for the discovery of the pulmonary circulation

Fracture penis with complete urethral disruption during intercourse

We present a rare case of fracture penis with complete urethral disruption in a 38 years old male. This resulted in an erect penis during sexual intercourse. He presented with diffuse and tense swelling of the penis along with acute urinary retention and distended urinary bladder. Emergency exploration revealed complete urethral disruption with tears in both corpus cavernosa. Evacuation of haematoma, repair of corpora and primary urethral repair was performed. Post-operative recovery was smooth and the patient developed satisfactory erectile and voiding function