Plastibell circumcision; seven years' experience

Design: Prospective Study

Setting: Different hospitals as a day care surgery

Period: March 2005 up to March 2012

Patients and Methods: Plastibell circumcision in infants and children's up to the age of 7 years was conducted using Plastibell device in different hospitals as a day care surgery

Results: In Plastibell method, local edema was minor complication then delayed separation of the ring, infection, mild bleeding after plastibell separation, respectively and no major complication was noted

Conclusion: Plastibell device circumcision prevents the most serious complications like bleeding, infection etc. It is fast and ensures excellent cosmoses and it takes short operating time

Multi nodular goiter; frequency of malignancy and its histopathological types. a tertiary care hospital experience

I. To determine the frequency of malignancy in multi nodular goiter. II. To determine the histopathological types. This is a prospective study. Surgical department of Foundation Hospital Rawalpindi and associated Teaching Hospital of Frontier Medical College Abbottabad. Aug. 2002 to Aug. 2007. One hundred patients with Multi nodular were included in this study. Patient with diffuse goiter, solitary nodules, patient operated somewhere else and suspected cases of malignancy were excluded from the study. Tissue were sent to Armed Force Institute for histopathological examination. Patients were followed for 2 weeks after surgery with histopathological report, all the preoperative and postoperative findings were recorded in detail. Data was analyzed byusing SPSS 14. Majority of patients studied, belonged to Azad Kashmir and Gilgit which are among the known endemic regions for goitre in Pakistan and other from Chakwal and Jhelum. Histopathology revealed 96 [96%] patients with multi nodular goiter, 3 [3%] papillary carcinoma and 1 [1%] Follicular carcinoma. Multinodularity of the goitre should not be considered as low risk of malignancy and delay for surgical intervention. Changes in the size of gland, the appearance of new and hard nodules or cervical lymphadenopathy may indicate malignant change and prompt indication for surgery

Lump breast; role of FNAC in diagnosis

Lump breast is a fairly common presenting complaint for which patient seeks medical advice and becomes anxious about the diagnosis. Fine needle aspiration cytology [FNAC] for the diagnosis of lump breast has been proved as a simple, rapid and economical procedure. The present study was done to evaluate the diagnostic accuracy of fine lump breast in our set-up compared with open biopsy. The study was conducted in surgical department of Nishtar hospital Multan and Frontier Medical College Abbottabad. One hundred female patients with lump breast were selected for the study and their medical history was recorded. The age range was 15-65 years. All of the patients under went FNAC of the lump breast followed by open biopsy for comparison. The results reveal that this study shows a sensitivity of 87.5% for FNAC to pick malignant lesions and specificity of 82.4% while over all diagnostic accuracy 84%. Fine needle aspiration cytology is safe, easy, cheap and accurate procedure. Its sensitivity and specificity is fairly high and is a good alternative to open biopsy. FNAC should be routinely used and open biopsy should be performed in doubtful cases only

Tamoxifen toxicity in breast cancer radiation

To see any added toxicity of tamoxifen when prescribed during radiotherapy in breast cancer. Treatment, Randomized, Open Label, Parallel Assignment. Department of Clinical Oncology Allied Hospital Faisalabad. Period: from February 2005 to June 2007. 300 patients were enrolled, age ranging from 22 to 73 years. Stage-I, II and III breast cancer were included in study. Staging was done on AJCC staging system. All were hormone positive. All patients were divided into two arms. Arm A, 150 patients given tamoxifen during radiation and arm B, 150 patients were given tamoxifen after completion of radiotherapy. All patients were examined for skin reactions and lung toxicity [pneumonitis] weekly and at six weeks after completion of radiation. Most of patients in both arms show skin reactions in 3[rd] week and pneumonitis around the end of treatment. Only 2% patients in each arm suffer from grade IV toxicity. Toxicity was manageable and comparable. There was no significant additional toxicity of concurrent use of tamoxifen with radiation

Aspiration and tetracycline sclerotherapy of primary vaginal hydrocoele of testis in adults

Primary Vaginal Hydrocoele of Testis is a common condition which is primarily treated surgically. Many patients with Hydrocoele of testis are either not willing or are unfit for surgery. This study was done to know the safety, efficacy and outcome of tetracycline induced sclerotherapy of Primary Vaginal Hydrocoele of Testis in adults. This quasi experimental study was done in Shahina Jamil Hospital, attached with Frontier Medical College and Ayub Teaching Hospital, Abbottabad from March 2006 to April, 2007. Thirty-seven patients with primary vaginal hydrocoele were included in the study. Aspiration and instillation of Tetracycline was done after spermatic cord block with 2% lignocaine. Procedure time, Peri and Post-procedure complications, number of injections for cure and patients' satisfaction with the procedure were recorded. Patients were discharged home 3 to 4 hours after the procedure and followed up after one week, one month, three months and six months. Direct admission and re-admissions were recorded. The mean age of patients was 47 years. Mean procedure time was 45 minutes. All patients were cured. Mild postprocedure pain occurred in 12 [40%], moderate pain in 14 [46%] patients and severe pain in 4 [13.3%] patients. No patient developed haematoma or local infection. One patient [3.3%] had micturition problem. Two [6.6%] patients had minimal recurrence. One injection was sufficient for cure in all patients. 28 [93%] patients were satisfied while 2 [6.6%] patients were not satisfied with this procedure. No patient was admitted in the hospital after the procedure. Aspiration and injection of tetracycline in Primary vaginal Hydrocoele of Testis in adults is safe, effective and very economical procedure

Diabetes Mellitus type 2; assessment of body mass index [BMI]

To assess the body mass index in patients with diabetes mellitus type 2 in a tertiary care hospital. Analytical [cross-sectional] study. The outpatient clinic at Shahina Jamil Trust Hospital Abbottabad from November 2006 to April 2007. One hundred patients seen in the outpatient clinic were enrolled in the study. All patients were 30 years of age or above, diagnosed as a case of diabetes mellitus were included. Patients with diabetes mellitus type 1 and pregnant diabetic women were excluded. Sixty-seven percent were females and thirty three percent were males. Mean age of the patients was 53.4 +/- 11.0 years [F: 51.9 +/- 12.0, M: 56.5 +/- 7.8] and mean duration of diabetes mellitus type 2 was 7.1 +/- 6.5 years [F: 7.1 +/- 6.4, M: 7.9 +/- 6.8], mean height of patients with DM type 2 was 1.5 +/- .09 m [F: 1.5 +/- .08, M: 1.6 +/- .08], mean weight was 71.4 +/- 14.3 kg [F: 70.1 +/- 15.0, M: 74.2 +/- 12.6], and mean BMI was 28.3 +/- 6.4 [F: 28.7 +/- 6.9, M: 27.5 +/- 5.2]. Among all patients, 34% [F: 23, M: 11] had normal weight, 28% [F: 17, M: 11] were overweight, 32% [F: 23, M: 9] were obese and 6% [F: 4, M: 2] had morbid obesity. There was strong association of obesity with type 2 diabetes mellitus with no significant difference of mean BMIs among male and female patients