Incidence of malignancy in prostatic enlargement: a prospective study conducted at Sheikh Zayed hospital and medical college, Rahim Yar Khan

The problem of enlarged prostate due to benign prostate hypertrophy and carcinoma prostate is becoming a great concern all over the world. Prostate cancer is a serious disease because it is a malignant condition. Early detection of carcinoma prostate at curable stage so with appropriate treatment, morbidity and mortality can be reduced. This present prospective and descriptive study was carried out from January 1999 to June 2001 to find out the incidence of malignancy in patients presented with prostatic enlargement at Sheikh Zayed Hospital, Rahim Yar Khan. Most of the patients who were diagnosed on histopathological repots were between 60 to 80 years of age. Patients got relieved their symptoms of prostatism for short period of time but ultimately they went into surgery either transvesical prostatectomy or transuretheral prostatectomy and reteropubic prostatectomy. Digital rectal examination [DRE] was performed in all these patients as a preliminary examination. The normal size of adult prostate is considered as chestnut, the enlarged lobes were rounded with palpable lateral margins with median groove in all of them. Out of 12 patients 8 patients had stony hard nodular with irregular surface, margins, palpable on digital rectal examination while other 4 patients were later on diagnosed on histopathalogical report to be carcinoma prostate. So the accuracy of DRE in this study is 66%. In 8 patients who had stony hard nodular prostate rectal mucosa was fixed on it and non-tender with irregular surface and in 3 patients finger was blood stained with ill defined lateral marsin. It is concluded that incidence of malignancy in patients presented with prostate enlargement in present study is compared and equal to study conducted in various centers

Primary torsion of the lesser sac omentum

Omentum torsion is rarely diagnosed preoperatively. Knowledge of the entity is important to the surgeon because it mimics the common causes of acute surgical abdomen. We present a case of acute abdominal pain in young lady with torsion of a segment of lesser omentum being diagnosed preoperatively as complicated peptic ulcer. Torsion of the omentum is a condition in which the organ twists on its long axis to such an extent that is vascularity is compromised. Although omental torsion is rarely diagnosed preoperatively, knowledge of the entity is important to the surgeon because it mimics the common causes of acute surgical abdomen. Torsion of omentum is known entity in medical literature but we had a case of torsion of segmental of lesser omentum that mimic peptic ulcer perforation

Management of liver abscess

Liver abscess is a common disease in Pakistan associated with higher morbidity and mortality. Early diagnosis offers the best chance of cure. This was a hospital based study from January 1999 to February 2001. To compare the results of different modalities available to treat the liver abscess. Secondly to find out which type of liver abscess is common in our region. Fifty patients of liver abscess were studied they were divided into three groups according to the size of the liver abscess [in group-I, 22 patients , in diagnosed in 45 cases [90%] and pyogenic in 5 cases [10%]. Maximum patients of group-I were treated by conservative treatment. Group-II patients with minimal invasive surgery and group-III were treated with open surgical treatment. Amoebic liver abscess was found in 45 cases [90%] and Pyogenic in 5 cases [10%]. After amoebis serological test and fluid examination for culture [aerobic, anaerobic, gramstainning] and colour of the fluid anchovy sauce in amoebic. Delay in the diagnosis/ treatment increases the severity of disease and difficulty in management. The patient can be managed easily by medical treatment when present early