ABSTRACT
To evaluate and compare the effectiveness of the modified Hong Kong procedure performed with and without additional instrumentation, in terms of improvement in neurological and kyphotic disabilities in spinal tuberculosis. Quasi-experimental study. Department of Orthopaedic Surgery, Rawalpindi General Hospital, Rawalpindi, from June 1999 to May 2006. Sixty-two cases of tuberculosis of spine, underwent modified Hong Kong procedure. In 44 cases [group A], no instrumentation was used, while in 18 cases [group B], additional anterior instrumentation in the form of narrow Dynamic Compression Plate [DCP], fixator spinae or Moss Miami instrumentation was used. Changes in the neurological status [following Frankel classification system] and kyphotic angle [as measured on X-ray] after an average of 18 months post-operative follow-up were evaluated and also compared between the two groups using t-test. There were 23 males and 39 females with mean age of 31.6 +/- 17.1 years. An average neurological improvement of 1.1 +/- 0.7 Frankel grade was achieved overall, which was statistically significant [p < 0.05]. There was no significant difference in degree of neurological improvement on comparing the two groups [p = 0.272]. In group A patients, mean improvement in kyphotic angle of 2.8 +/- 5.5 was achieved. In group B patients, treated with additional instrumentation, an average 8.9 +/- 7.6 correction was recorded. The difference in improvement between the two groups was statistically significant [p < 0.05]. Modified Hong Kong procedure alone for spinal tuberculosis [TB] was successful in producing significant neurological recovery. The addition of stabilization instruments achieved better and maintained correction of kyphosis
Subject(s)
Humans , Male , Female , Neurologic Manifestations , Kyphosis , Treatment OutcomeABSTRACT
CMF regimen contains Cyclophosphamide. Methotrexate and 5-fluorouracil which was developed in "Istituto Nazionale Tumori in Milan and has found to be effective in both pie-menopausal and post-menopausal breast cancer patients. Since it contains some hepatotoxic drug components so we tried to evaluate the cumulative hepatotoxicity of this combination, both in acute and chronic phases. In case of acute toxicity the regimen is found to be safe. However in case of chronic toxicity, it is found to produce mild effects in patients receiving less than three cycles and moderate effects in patients receiving more than three cycles. This represents that benefit versus risk should be assessed before giving CMF regimen to the patients, especially when other drugs like analgesics or antidepressants are prescribed with it
ABSTRACT
Consanguinity is relationship by blood that is being descended from common ancestors. In Pakistan marriages among tribes and cousins are common. Consequently it weakens the genetic material. Lethal mutated gene which is usually recessive are covered by normal dominant allets. Repeated marriages in the same family or tribes increases the risk of expression of lethal recessive genes. The result of repeated cousin marriages is increased risk of having offsprings with fetal abnormalities
Subject(s)
Humans , Female , Pregnancy Outcome , Congenital AbnormalitiesABSTRACT
In the present work, thirty nine [39] patients were randomly selected from Radiotherapy Department of Jinnah Post Graduate Medical Center, Karachi. The criteria of inclusion was, females of postmenopausal age, biopsy proven breast cancer [unilateral or bilateral], mastectomy with auxiliary clearance within fifteen days, without radiation or hormonal therapy and no clinical metastasis was present and twelve postmenopausal controls were also selected, for comparison. This study leads to discovery that there is a correlation of estrogen and progesterone in breast cancer women in Karachi, and this relationship is reciprocal, estrogen level increases with decrease in estrogen receptor showing aggressiveness in disease