Computed tomography in management of patients with non-localizing headache

To assess the usefulness of a computed tomography scan in patients with non-localized headache. One-hundred and forty-two patients with non-localized headache were included in a retrospective study after reviewing the medical records of 896 patients at the Radiology Department, Sultan Qaboos University Hospital Patients with neurological deficits, head injury, previous intracranial intervention, or malignancy were excluded. Radiological findings of all patients were reviewed and results were divided into 3 groups: 1] no intracranial abnormality; 2] with clinically significant intracranial abnormality; and 3] positive without clinical significance or with extracranial abnormality. All patient history records were reviewed for a period of six months following their initial computed tomography scan to assess their clinical outcomes. The cost of computed tomography examination and patient radiation dose were calculated. Of the 142 patients, 64% were females and 36% males [7% pediatric] with an age range of 4-87 years [mean: 36.2 years]. Among the patients, 70% demonstrated negative computed tomography findings [grade 1], only 4% showed clinically significant findings [grade 2], and 26% demonstrated incidental positive findings with no clinical significance [grade 3]. The average cost of computed tomography head examination was approximately 60 Omani Riyal [$156]. The clinically significant positive cases were fewer than expected. The average estimated radiation dose for these patients was calculated and found to be around 5 times the radiation from computed tomography of the sinuses [approximately 1.84 mSv]. Computed tomography head imaging in patients with non-localized headache has a low likelihood for any significant intracranial lesion. Therefore, it is essential to develop local standard operating procedures to promote better utilization of this type of imaging service

Laparoscopic complications in the learning phase:our experience in the first 75 cases

To identify factors responsible for serious complications in learning phase of Laparoscopic surgery. Retrospective study of 75 patients undergoing Laparoscopic cholecystectomy. Surgical Units of D.H.Q. and Holy Family Hospital of Rawalpindi Medical College. Seventy five patients of cholelithiasis who had laparoscopic cholecystectomy done. Operative problems, conversion to open cholecystectomy, postoperative complications and hospital stay in patients having laparoscopic surgery. Overall conversion rate was 16% operative complications included one common bile duct injury and one case of duodenaI injury. Postoperative complications were infection of trocar site in 8%and subhepatic collection in 4% cases. Proper selection of patients, two or more experienced surgeons operating together and low threshold for conversion to open procedure reduces the risk of serious complications in the learning phase of laparoscopic surgery