ABSTRACT
Introduction: In Homo sapiens and other mammalianquadrupeds, there is an absence of posterior rectus sheathbelow the arcuate line and insubstantial transversalis fasciain groin. This anatomical arrangement presents no particularfunctional, anatomic difficulty for quadrupeds as their inguinalcanal is directed uphill during ambulation and therefore isnot subjected to significant gravitational stress. Aims andobjectives: To evaluate the efficacy of bipedicled strip ofexternal oblique aponeurosis for augmentation of posteriorwall of inguinal canal in inguinal hernia repair.Material and methods: This study was carried out onfifty consecutive patients of inguinal hernia admitted in theSurgery Department of Guru Nanak Dev Hospital attached toGovernment Medical College, Amritsar.Conclusion: The present study was an attempt to evaluatethe role of bipedicled strip of external oblique aponeurosis inaugmentation of posterior wall of inguinal canal in inguinalhernia repair. Our findings suggest that the bipedicledundetached strip of external oblique aponeurosis is as efficientas a synthetic mesh in inguinal hernia repair. This repair isalso economically more beneficial for poor patients whocannot afford to have mesh repair. Although the present studyis small and follow up period is short but we still recommendthis procedure as a good alternative to Modified Bassini’s,Shouldice repair and mesh based repairs
ABSTRACT
Wounds and their management are fundamental to the practice of surgery, as any kind of surgical intervention will result in a wound. Post operative wound complication is common, but sometimes a difficult event is experienced by a surgeon. A similar situation is a faecal fistula. Aims and objectives: 1.To Identify various causes of fecal fistula and there management in surgical patients. Methods: The present study was conducted in the Department of Surgery, GMC, Jammu w-e-f 1-11-2014 to 31-10-2015. Patients admitted in various surgical units of the department were incorporated in study design. Presenting features and detailed history of the disease was recorded as per enclosed proforma. Inclusion Criteria: All patients developing faecal fistula following open/laparoscopic abdominal surgery both elective and emergency cases including Gynaecological /vascular/ thoracoabdominal/ urological surgeries. Exclusion Criteria: Pharyngeal, oesophageal, anorectal and urinary fistulas were excluded from the study. Results: Among twenty five patients of small bowel fistula in our series, thirteen patients had spontaneous closure within 30.7 days with the range of 14 days (a case of post LSCS faecal fistula) to 70 days (a case operated for intestinal obstruction). Conclusion: In the end it is concluded that faecal fistula is a post operative complication with significant morbidity and mortality in relation to patient on one side and a lot of dedicated effort in limiting the morbidity(malnutrition,electrolyte imbalance,sepsis) to be performed by a doctor on the other side with utmost care of the patient with faecal fistula.
ABSTRACT
Diabetes Mellitus is the fifth leading cause of death globally. Liver disease is one of the leading cause of death in persons with Type 2 Diabetes Mellitus (T2DM) (1). T2DM is considered as a risk factor for gallstone disease. Cholelithiasis is associated with such risk factors as ageing, obesity, female sex genetic predisposition, alcohol abuse, hypercholesterolemia (2). Aims and objectives: 1.To study the Prevalence of Cholelithiasis in Patients with Type 2 Diabetes Mellitus in North Indian Population. Methods: All Patients presenting to OPD with diagnosis of T2DM from January 2017 to December 2018 with Cholelithiasis were included in the study. Diagnosis of Cholelithiasis was verified on clinical data, gall bladder wall thickness and ultrasonography. Results & Conclusion: There is higher prevalence of gall stone disease compared to controls however gall stone disease is multifactorial and only NIDDM females was an independent risk factor. Increasing age, female sex, genetic predisposition, hypercholesterolemia with low HDL cholesterol and higher BMI are independently associated with gall stones.
ABSTRACT
In Homo sapiens and other mammalian quadrupeds, there is an absence of posterior rectus sheath below the arcuate line and insubstantial transversalis fascia in groin. This anatomical arrangement presents no particular functional, anatomic difficulty for quadrupeds as their inguinal canal is directed uphill during ambulation and therefore is not subjected to significant gravitational stress. Aims and objectives: To evaluate the efficacy of bipedicled strip of external oblique aponeurosis for augmentation of posterior wall of inguinal canal in inguinal hernia repair. Material and methods: This study was carried out on fifty consecutive patients of inguinal hernia admitted in the Surgery Department of Guru Nanak Dev Hospital attached to Government Medical College, Amritsar. Conclusion :The present study was an attempt to evaluate the role of bipedicled strip of external oblique aponeurosis in augmentation of posterior wall of inguinal canal in inguinal hernia repair. Our findings suggest that the bipedicled undetached strip of external oblique aponeurosis is as efficient as a synthetic mesh in inguinal hernia repair. This repair is also economically more beneficial for poor patients who cannot afford to have mesh repair. Although the present study is small and follow up period is short but we still recommend this procedure as a good alternative to Modified Bassini's, Shouldice repair and mesh based repairs.
ABSTRACT
There has been an increasing trend towards the use of drugs in both the progression and treatment of AUR due to prostatic obstruction. The immediate management of AUR requires bladder decompression by catheterisation. Until recently, secondary management consisted exclusively of BPH surgery performed either within a few days after AUR (emergency surgery) or within 1 to 3 months after the event, with the patient returning home with a catheter in situ during the interval. AIMS AND OBJECTIVE: 1. To study the efficacy of alfuzosin in acute urinary retention. 2. To observe its side effects. MATERIAL AMD METHODS: Group I (Control): 50 patients were taken under consideration and advised analgesics/antibiotics as and when required during trial period. Group II (Study): 50 patients were given Tab. Alfuzosin 10mg in morning and analgesic/antibiotics as and when required during trial period. These patients were catheterized and catheter was removed after 3 days.
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To describe the clinical presentations of hepatitis B virus infection in children. Children presenting with symptoms of liver diseases and other diseases who were found to be HBsAg positive by screening or ELISA method were enrolled. Children suffering from thalassemia, hemophilia and hemolytic anemia, which need multiple transfusions, were excluded. On the basis of history, examination and investigations the clinical presentation of the patient was categorized. Basic demographic data, relevant clinical history, physical examination, lab investigations and clinical presentations category were entered in the predesigned proforma. As this is the descriptive study, no hypothesis were required. Descriptive case series. Paediatric unit-2 Nishtar Hospital Multan. 16[th] May 2012 to 15th November 2012. Study results consist of relative frequencies of different clinical presentations of HBsAg positive patients. Fifty children who were HBsAg positive were enrolled in a six month period. Out of 50 patients, 21 [42%] were of hepatic encephalopathy, 14 [28%] were with acute hepatitis, 12 [24%] were cirrhosis, 2 [4%] were asymptomatic carrier and 1 [2%] was presented with chronic hepatitis B. There were 40 [80%] males and 10 [20%] females. The overall male to female ratio was 4:1. Most common presentation was hepatic encephalopathy which has a very bad prognosis, next comes the acute hepatitis and then cirrhosis. There is another inference that males are more and severely affected by hepatitis-B virus infection
Subject(s)
Humans , Male , Female , Hepatitis B, Chronic/complications , Communicable Diseases , Child , Liver Diseases , Hepatitis B virus/pathogenicityABSTRACT
To assess the gender differences among pulmonary tuberculosis suspects undergoing diagnostic sputum smear microscopy. This retrospective study was carried out in the Department of Physiology Nishtar Hospital Multan in collaboration with Department of Chest Medicine and Tuberculosis. Data from January 2005 and October 2007 were analyzed. The hospital records of newly diagnosed patients of pulmonary tuberculosis were selected. The patients were classified into various groups according to gender and age. Female/Male ratio of more than one [1.05/1] was found among pulmonary tuberculosis aspects undergoing sputum examination attending the Out Patient Department of Chest Medicine, however, AFB sputum smear positive cases were less among female patients, and female/male ratio was less than one [0.84/1.0]. The overall AFB sputum smear positive cases were significantly higher in male patients. Gender and age are both traditionally known variables in terms of incidence and prevalence of pulmonary tuberculosis. The existing gender disparity and pattern of gender specific treatment seeking is one of such indicators, which call for more attention to both males and females, especially productive age group
Subject(s)
Humans , Male , Female , Aged , Child , Adolescent , Adult , Middle Aged , Prevalence , Sex Distribution , Retrospective StudiesABSTRACT
To find out the incidence of AFB smear positive patients of pulmonary tuberculosis who presented to out - patient department of chest medicine from January 2005 to October 2007. This retrospective study was carried out in the Department of Physiology in collaboration with Department of Chest Medicine and Tuberculosis Nishtar Hospital Multan. In this study, the hospital records of newly diagnosed patients of pulmonary tuberculosis were analyezd. The patients were classified into, various groups according to age and gender. The incidence of AFB smear positive patients and frequency of the presentation was calculated. The overall percentage of AFB smear positive cases between January 2005 and October 2007 in region of Multan was 22.16%, but it has dropped gradually from 2005 to 2007 both in male and female patients. A higher incidence was seen in population ranging in age between 10-30 years. Sputum smear examination for AFB is simple and cost-effective method to provide a fairly realistic estimate of the incidence or prevalence of tuberculosis. Although there was a decreasing trend in the incidence of AFB smear positive cases from 2005 to 2007, the high burden of tuberculosis among Pakistani population still warrants renewed and enhanced efforts to control TB. The higher prevalence of persistent cough and AFB-positive sputum smears need further exploration