Lumbar discectomy; comparative study of endoscopic VS fenestration operation

Discectomy is the standard treatment for lumber disc disease. Fenestration operations involved lot of issue dissection and so the complications Instead the endoscopic discectomy involved less tissue dissection but limited exposure. The objectives of this study were to compare the outcome of endoscopic discectomy and fenestration discectomy interms of relieve from symptoms and complications. Analytic study. Neurosurgical unit Bahawal Victoria hospital Bahawalpur, from Feb 2010 to Aug 2010. Forty cases fulfilling the inclusion criteria were selected. Efficacy of procedure was determined by improvement in Denis pain scale, Macnab's criteria and straight leg raising [SLR] improvement. Forty patients divided in two equal groups. Patients of group A underwent fenestration and Group B endoscopic discectomy 60%of patients had left sciatica while 40% of patients had right sciatica. According to Denis pain scale 10% patients had moderate pain, 30% had severe pain and 60% had constant pain. Straight leg raising test showed, 50% patients had less than 30° SIR, 3O%patients showed SLR of 31 ° to 40 and 2O%patients had SLR more than 40°. MRI findings were disc bulging, protrusion and rupture. Considering SLR, Denis pain scale and Mcnab's criteria of pain control there was no clinical difference found between the two operative procedures except in two patients in group B when open discectomy had to be performed. MED is a safe and effective mode of treatment for low back pain in patients with lumbar disc herniation

Complications in cases of enteric perforation

Enteric perforation is a disastrous complication of untreated or poorly treated typhoid fever and unless treated by surgical method, it results in considerable morbidity and mortality. The purpose of this study to describe complications of ileostomy in patients of enteric perforation. The study was conducted was in surgical units B-V hospital, Bahawalpur from 1[st] July 2008 to 30[th] June 2009. This was a descriptive case series study. 100 patients of both genders suffering from typhoid fever with perforation who underwent ileostomy were included the study. All the data was collected on pre-designed proforma. Most of the patients were young with male to female ratio 1.6:1. Ileostomy was done in all the patients after cleaning the peritoneal cavity. Ileostomy was associated with diarrhea 20%, peristomal skin problems 22%. Other complications were bleeding in 3%,prolapsed in 5%, retraction in 4%, parastomal hernia in 5%, wound infection in 8%, intestinal obstruction in 5% patients, incisional hernia and psychological symptoms in 2% patients and stoma stenosis in one patient in our study. Two patients expired due the complication of ileostomy. Although ileostomy is not the most favored way of treatment of enteric perforation and it is associated with a number of complications and management problems, it is still a good option and life saving procedure in our setup where patients present very late with gross peritoneal contamination

Risk factors; comparison in hepatitis B and C carrier pregnant women and healthy pregnant women

To determine the risk factors associated with hepatitis B and C carriers versus healthy pregnant women. It was a single center based, cross sectional comparative study, conducted at Gynae ward II, B-V hospital Bahawalpur. Duration of study was from March to August 2008. 100 patients were enrolled in the two groups, 50 HbsAg/Anti HCV positive women [cases] to compare with 50 healthy women [controls] match for parity. The data were recorded on a proforma. 100 pregnant women were enrolled. Sixty eight [68.0%] were aged 25 years or less with a mean age +/- S.D of 24.62 +/- 3.40. Ten [20%] women had HBV and 40[80%] were HCV positive. The risk factors were compared between the two groups by uni-variate and multivariate analysis which showed that history of dental treatment, blood transfusion, surgery, parenteral treatment and jaundice were significant risk factors for hepatitis B and C carrier status. There appears to be a strong co-relation of history of blood transfusion and dental treatment with HbsAg/ Anti HCV carrier state in pregnant women. The anti HCV seropositivity was appreciably high [80%] as compared to HbsAg [20%] in carrier pregnant women

Abdominal tuberculosis;Still the great mimicker

To study the different clinical presentations, operative and postoperative course of abdominal tuberculosis. Case series study. Surgical units, Bahawal Vicotria Hospital, Bahawalpur. May 01, 2005 to April 30, 2007. This was a prospective type of case series study. A selection criterion of patients was that all patients of either sex and age being diagnosed as case of abdominal tuberculosis. The clinical record of the patient's data, symptoms and signs, biopsy report, biochemical and radiological report, treatment [surgery and chemotherapy] given and a follow-up. Total 96 patients presented with abdominal tuberculosis, 60[62.5%] were male and 36[37.5%] were female. Peritonitis was present in 48[50%] patients, intestinal obstruction[acute and sub-acute] was present in 32[33.33%] patients, mass right iliac fossa was present in 14[14.58%] patients and 2[2.08%] patient presented with mass in the epigastrium. 28[29.16%] patients has concurrent pulmonary tuberculosis. Two patients expired so mortality rate was 2.08%. The control of TB has been a challenging problem because the natural history of the disease and its varying pattern in which it manifests is in different groups

Extra nodal lymphoma

To study the different clinical presentations and treatment options of extra nodal lymphoma. Prospective. Surgical Unit, Bhawal Victoria Hospital, Bahawalpur from May 01,2000 to April 30,2004. Patients of either sex and age diagnosed as case of extra nodal lymphoma were included in the study. The clinical record of the patients included biodata, symptoms and signs, biopsy report, biochemical and radiology report, treatment [surgery, chemotherapy, radiotherapy] given and follow up. In this study we had 13 patients. Out of these 4[31%] were female and 9[69%] were male. Extra nodal sites included GIT [54%], testis [15%] spinal cord [15%] and skin [15%]. The prognosis in most of the cases was not so good. Due to this extensive presence of lymphatic tissue, lymphoma can develop in and spread to, almost any part of the body, For the treatment purpose staging of the disease is very important like any cancer, the earlier the lymphoma is diagnosed, the easier it is to treat