ABSTRACT
Background: Acute appendicitis is one of the most common cause of acute abdomen surgery. Several scoring systems have been adopted by physicians to aid in the diagnosis and decrease the negative appendicectomy rate. Tzanakis scoring system is one such score. Objective of present study was the validation of this scoring system in our population and compare its accuracy with histopathological examination (HPE).Methods: A retrospective study was carried out at the Department of Surgery at Mohammad Afzal Beigh Memorial Hospital Anantnag India. Tzanakis score was calculated in 288 patients who underwent appendicectomy from September 2016-2018 and HPE results were analysed.Results: 276 patients were eligible for the study. The sensitivity and specificity of Tzanakis score in diagnosing appendicitis was 90.66% and 73.68% respectively. The overall diagnostic accuracy was 86.23% with positive predictive value of 97.89% and negative predictive value of 36.84%.Conclusions: Tzanakis scoring system is an accurate modality in establishing the diagnosis of acute appendicitis and preventing a negative laparotomy.
ABSTRACT
Objective: To determine the effect of supplementaloxygen on APGAR score of newborn babies, givento pregnant ladies undergoing elective lowersegment caesarian section under spinal anesthesia
Study Design: Cohort study
Place and durationof study: Combined Military hospital Rawalpindi,from Jun 2010 to Mar 2011
Methodology: Onehundred and twenty full term pregnant ladies wereenrolled by non probability consecutive sampling,who were scheduled for elective caesarian sectionunder spinal anesthesia. The patients wererandomized into two groups [A and B]. In patientsof Group A supplementation of oxygen was given tothe mothers after spinal block, while in Group B,patients were not provided with supplementaloxygen after spinal anesthesia. Cases requiringgeneral anesthesia or supplemental oxygen [in groupB] for some other reasons causing maternal hypoxiawere excluded from the study. APGAR Score at oneminute and five minute was recorded
Results: Intotal of one twenty newborns, 56 [47%] were malesand 64 [53%] females. Mean age of the pregnantladies under study was 35 + 5 in group A and 33 + 7in group B. In group A, the value of APGAR scoreat one minute varied from 6 to 10 and, at fiveminute it was from 8 to 10. While in group B, theresults of APGAR score were same without anysignificant difference [P>0.05]
Conclusion:Supplemental oxygen has no role on the APGARscore of newborns but simple psychologicalsatisfaction to some of the mothers at the cost ofwastage of oxygen while in some patients causinganxiety, so patients should be educated on thisaspect and un-necessary use of supplemental oxygenmust be avoided
ABSTRACT
To determine the prevalence of Erectile Dysfunction [ED] in hemodialysis patients [HD] and to study the associated changes in sex hormones in these patients. This is a hospital based cross sectional study conducted at hemodialysis units of Shalamar and Mayo Hospitals, Lahore from January to March 2008. All male patients with ESRD on maintenance [HD], whose spouses were alive and able to perform intercourse, were included in the study. Patients with cognitive and communication deficits were excluded from study. International index of erectile function-5[IIEF-5], adopted in Urdu was used for determination of prevalence of ED. Demographic data was collected and sex hormones [total testosterone, Dihydroepiandrosteronediones [DHEA], Follicle Stimulating Hormone [FSH], Leutinizing Hormone [LH] and serum Prolactin] were measured. A total number of fifty patients were included in the study. The major cause of ESRD was diabetes mellitus 28 [56%]. The prevalence of ED was 86% with a mean IIEF-5 score 10.36 +/- 7.13. The majority of patients, 33 [66%], were suffering from a severe degree of ED. The total testosterone level was low in 30 [60%] patients and DHEA were low normal in most of patients, 46 [92%]. Compared to patients with non-ED, those with ED had a significantly lower DHEA [1.93 +/- 0.73 vs 0.81 +/- 0.11, p value = 0.007]. Total testosterone and DHEA had a negative correlation with age and diabetes mellitus. FSH showed a variable response in these patients, it was low [< 1.55 mIU/ml] in three, normal [1.55 +/- 9.74 mIU/ml] in 39 and high [> 9.74 mIU/ml] in eight patients. LH was low [< 1.2 mIU/ml] in two, normal [1.2 +/- 7.8 mIU/ml] in thirty three and high [> 7.8 mIU/ml] in fifteen patients. FSH and LH showed a positive correlation with duration of dialysis. Prolactin level was low in 21[42%] patients. Total testosterone, FSH, LH and Prolactin had no association with ED. The majority of the patients suffering from ESRD, on maintenance HD had ED. DHEA was significantly lower in patients with ED, compared to those with no-ED. Total testosterone and DHEA had an inverse relationship with diabetes and age of the patients. Total testosterone, FSH, LH and prolactin did not affect erectile function