Yemeni experience with phacoemulsification

To evaluate the first experience of phacoemulsification in Yemen from 2000-2007 regarding the visual results, and complications. Two hundred and fifty-eight eyes of 182 adult patients with significant cataract were included during the last 96 months. All eyes underwent phacoemulsification with implantation of intraocular lenses. The results were recorded and statistically analyzed. The male:female ratio was 1:1, with an average age of 52 years. Phacoemulsification was carried out by scleral approach in 14 eyes, and by clear corneal approach in 244 eyes. A visual acuity of >/= 6/18 was achieved in 85.3%, and the most common serious complication was intraoperative posterior capsule rupture, which was reported in approximately 10.1%. The results of phacoemulsification are very impressive, and the most common intraoperative complication was ruptured posterior capsule

Echocardiographic profile of rheumatic heart disease at a tertiary cardiac centre

Rheumatic Heart Disease [RHD] continues to be a major public health problem in developing countries like Pakistan. Objective of this cross sectional-analytical study was to analyze the severity of valvular lesions on echocardiography in patients pre-diagnosed with RHD. The transthoracic echocardiographic records of RHD patients from 2004 to 2008 were retrospectively reviewed for type and degree of valvular involvement according to AHA/ACC guidelines. A total of 13, 414 patients [7, 219 Males [53.8%], 6, 195 Females[46.2%]] ranging from 11 to 90 years with a mean age of 42.33 +/- 18.976 were studied. On echocardiography, 7, 500 [56%] had mitral regurgitation [8.8% severe MR], 6, 449 [48.2%] had tricuspid regurgitation [7.1% severe TR] and 5, 550 [41.4%] had aortic regurgitation [8.8% severe MR], 6, 449 [48.2%] had tricuspid regurgitation [7.1% severe TR] and 5, 550 [41.4$] had aortic regurgitation [4.8% severe AR]. MS was detected in 2, 729 [20.3%] patients [15.3% severe MS], AS in 102 [0.8%] and TS in 31 [0.2%] patients. Mixed mitral valve disease was seen in 3, 185 [23.7%], mixed aortic valve disease in 222 [1.7%] and mixed tricuspid valve disease in 47 [0.4%] patients. All three valves were involved in 2, 826 [21.06%] patients, combination of mitral and aortic valves in 3, 103 [23.13%], mitral and tricuspid in 3, 784 [28.2%], and mitral only in 3, 701 [27.59%] patients. There was some mitral valve abnormality in all patients. Mitral valve was most commonly affected, while regurgitant lesions were more common than stenotic lesions, and most severe in younger patients. All valvular lesions had almost an equal distribution among the sexes, except aortic regurgitation, which was more common in females. Therefore, echocardiography should be done routinely for patients with RHD, focusing on younger population, to facilitate diagnosis and definitive treatment before complications set in

Effect of passive smoking and the use of harm reduction strategies by parents on the health of their asthmatic and non-asthmatic children

This study was design to assess the effort taken by parents of both asthmatic and non asthmatic children to reduce the adverse effects of smoking at home through the use of harm reduction strategies. A case-control study was conducted covering 2 hospitals in Mosil city. A total of 304 children [age 6-11.99 years] were included [110 asthmatic children, and 194 controls]. Data was collected from the parents, and lung function tests was done to all the children in the sample. Eighty percent of parents of cases did certain measures to protect their children from environmental tobacco smoke compared to 93.3% of parents in control group with significant difference between them, the number of measures used by parents in both groups significantly differ, but when the number of measures used by parents in both groups were compared with results of lung function tests of children there were no significant differences between them. Majority of parents agreed that tobacco smoke harm a great deal or quite a lot; yet, only 1% of parents in the control group and non of parents in the asthmatic children group agreed to stop smoking at home as a measure to reduce the adverse effects of tobacco smoke. Lung function tests of the included children show no significant difference when studied with the numbers of harm reduction measures used by their parents

Intussusception; management in infants and children in our setup

To review our results of management and compare them with other published series. Retrospective study. July 1995 to June 2006. Department of Paediatric Surgery, Allied Hospital, Faisalabad. The record of all patients was reviewed. A total of 102 patients were managed during this period. They were predominantly males. Eighty four percent were under 1 year while more than half under 6 months. Two thirds four of the cases presented between the months of March and August. Intussusception was preceded by a about of acute gastroenteries in over one third of the cases. Mean duration of symptoms before presentation was 72 hours. All cases except one, under went surgical exploration. At operation resection and anastomosis had to be done in nearly 60%. Wound infection [12%] and wound dehiscence [2%] were the major complications. Mortality rate was 8%. The management of intussusception in our setting is unsatisfactory when compared to the international standards. A high index of suspicion leading to early coupled with an inprocement in the management standards is needed

Pericardial effusion in acute myocardial infarction: frequency and in-hospital course

To determine the frequency and in-hospital course of pericardial effusion in acute myocardial infarction in our population. Prospective observational study. The study was conducted in the Department of Cardiology and Medicine, Mayo Hospital, Lahore. One hundred consecutive patients presented within first 24 hours of first episode of ST elevation myocardial infarction [STEMI] were studied. Patients with known coronary artery disease [CAD], chronic renal failure, collagen vascular disease, cardiac surgery and metastatic disease were [PE] was considered to be present when separation between two pericardial layers persisted throughout the cardiac cycle. Among 100 patients who were enrolled, 27 developed PE. Frequency of baseline variable like age, gender, and risk factors for coronary artery disease including hypertension, smoking, and diabetes mellitus were same in patients who developed PE when compared to those who did not. Most of the PE was detected on day 5 of the admission. About 82% patients had mild PE [only posteriorly and <10 mm]. Moderate PE was detected on day 5 of the admission. About 82% patients had mild PE [only posteriorly and < 10 mm]. Moderate PE was detected in 18% [present all around and between 10-20 mm]. None of the patients developed large PE [>20 mm]. About 15% patients who were thrombolysed and 40% who could not be thrombolysed developed PE [p <0.01]. Frequency of PE was statistically highly significant [p <0.001] among patients with higher Killip class and lower ejection fraction at the time of presentation. Patients who developed PE had statistically significant longer hospital stay [p <0.001] and higher in-hospital mortality [p<0.05].Thrombolysis decreased the frequency of PE in acute STEMI. Development of PE during the course of acute STEMI has prognostic implications and early invasive strategy may be offered for patients who develop this complication

Experience with permanent pacemaker implantation at Mayo Hospital, Lahore

Permanent pacemaker implantation procedure was started at Mayo Hospital, Lahore in March, 1978. Till December 31st 1998 nine hundred and sixty six permanent pacemakers had been implanted in this institution. 53% patients were males and 47% patients were females. 55% patients were between 50-70 years old. The youngest patient was only six months old while maximum age of the patients implanted with permanent pacemaker was ninety nine years old. 92% patients had fist implant while 6% patient had second implant and 2% patient had third implant. 84% patients had complete heart block, 5.5% patients had sick sinus syndrome, 2.7% patients had symptomatic second degree heart block, 2.6% patients had congenital heart block

pattern of general surgical problems among pilgrims admitted to King Fahad Hospital Al-Medinah Al-Munawarah 1987

During the 1987 Haj, 65 pilgrims were admitted to the General Surgical Department of the King Fahad Hospital, Al Medinah Al Munawarah, Saudi Arabia-47 [72.3%] male and 18 [27.7%] female. Their ages ranged from 20 to 80 years [mean 55.3 years]; 22 had operative treatment and 43 were treated conservatively. Blunt abdominal trauma after road traffic accidents was the commonest problem [23%]. The average hospital stay was 6 days. Before the Haj pilgrimage 40 patients were admitted and 25 were admitted after. Twelve patients discharged themselves against medical advice and six patients could not manage to perform the pilgrimage