ABSTRACT
To compare the frequency of synechiae formation in patients with nasal polyps undergoing endoscopic sinus surgery with and without using microdebrider. This study was conducted at ENT department of Fatima Memorial College of Medicine and Dentistry, Lahore and Central Park Medical College, Lahore/Kasur between June 2008 and June 2009. One hundred patients with nasal polyps were included who, after thorough examination and investigations, underwent endoscopic sinus surgery with and without microdebrider. The mean age of patients in group A [Microdebrider endoscopic sinus surgery] was 32.6 +/- 10.43 years. Male to female ratio was 1:1.08 in group A and 1.17:1 in group B. Synechiae formation after 4 weeks was 8% in group A and 10% in group B [p=0.5]. There is no difference between both groups after 2nd and 4th postoperative week of synechiae formation
ABSTRACT
According to Courvoisier's law; if gallbladder is palpable in a jaundiced patient, it is unlikely to be due to gallstones, because stones would have given rise to chronic inflammation and subsequently fibrosis of gallbladder therefore, rendering it incapable of dilatation. Conversely, the causes other than stone [principally tumours], would result in the distension of gallbladder, felt on abdominal palpation. However, in Courvoisier study of 109 cases of dilatation of gallbladder, 17 were due to impacted stones. Therefore, Courvoisier concluded that dilatation of gallbladder was rare with stones obstructing the common bile duct. Despite this fact it is always assumed that the palpable gallbladder is due to malignancy [pancreatic or periampullary etc.]. Here, we report a rare case of palpable gallbladder in a jaundiced patient due to multiple cholelithiasis and a large choledocholithiasis causing obstruction of CBD
Subject(s)
Humans , Female , CholedocholithiasisABSTRACT
Pain is a universal experience that serves the vital function of triggering avoidance. Pain and psychiatric disorders have a close relationship but the fact of the matter is that till date in Pakistan the extent of the pain related to musculoskeletal system presenting as a feature into various psychiatric disorders has not been established as yet and above all this kind of presentation is not uncommon. To identify the frequency of pain presentation, originating from musculoskeletal system in various psychiatric disorders. The study duration was one month, It was an observational prospective study done in out patient department Sindh Govt Lyari general hospital. The patients who has presented with pain having origin from musculoskeletal system irrespective of age and sex was included in study. All the patients having physical illness as co-morbidity were excluded. ICD-10 was used as diagnostic criteria. Statistical analysis was done on SPSS. 135 patients out of total no. of 504 patients presented with pain originating from musculoskeletal system suggesting that the incidence is high. The pain site along with variation of age and sex were interesting and could guide us to set management strategies to help these patients at rapid rate and henceforth reduce their sufferings which by all means are quite intense and to some extent resistant to treat. Further long term studies are needed to examine the presentation of pain in psychiatric disorders, to develop better insight in dynamics of pain, its perception and its response to treatment. This in turn will establish rapid and smooth recovery to this segment of patients