audit of laparotomies; carried out in combined military hospital Panno Aqil over three years period

To make an audit of laparotomies carried out at Combined Military Hospital Pano Aqil over a three year period. Cross sectional, retrospective study. Study was carried out at surgical department of combined military hospital Panno Aqil over a period of three years from Jan 2009 to Dec 2011. Patients with significant intra-abdominal pathology presenting as acute abdomen and who underwent laparotomy were included in study. Patients were either electively admitted via outpatient department or through Accident and Emergency [A and E] department. Patient charts and records were used to collect data. All 174 patients underwent laparotomy. In [27.6%] cases, intestinal perforation was the underlying cause; gynaecological pathology was found in [21.2%] patients. In 19.5% cases blunt and penetrating abdominal trauma was the cause of acute abdomen. Acute intestinal obstruction was found in [21.3%], tumors were found in [7.9%] and miscellaneous causes were identified in [2.3%] cases. Laparotomies carried out at Combined Military Hospital Pano Aqil fulfilled the evidence based medicine criteria

Clavicle fractures; incidence a two years study

To emphasize upon the frequency of fractures of clavicle due to indirect blunt trauma caused by road traffic accidents and falls from heights and their sequalae. Observational descriptive study. Combined Military Hospital Bannu during a period of two years from June 2003 to May 2005. Patients included in the study were the trauma patients brought to Combined Military Hospital Bannu during a civil -military conflict in tribal areas of North and South Waziristan. Patients had sustained multiple injuries mostly due to road traffic accidents in hilly terrain, falls from heights and combat scuffles. Out of these trauma victims, 746 patients fractures of the clavicle were grouped, analyzed, treated with standard treatment methods and patients were followed up for the varying periods of time. Out of 746 patients treated at our hospital, 84 were having fracture of clavicle [10.8%]. 53 patients [63.1%] with clavicle fracture had fracture involving middle third of the clavicle, 20 patients [23.8%] had fracture of lateral third, and 11 patients [13.1%] had fractures involving medial third of the clavicle. Clavicle is a bone which is at risk of fracture in cases of indirect blunt trauma because the first human reaction in any violence or assault is to protect oneself by using the upper limbs. Its peculiar development and anatomical shape makes it vulnerable to fracture in most physical insults. However, it usually unites by conservative methods and even considerable non-union does not significantly affect function

Treatment of acute lumbago; low dose diclofenac sodium with vitamin-B complex compared with diclofenac alone

To determine whether concomitant use of vitamins B1, B6, B12 along with low dose of diclofenac sodium causes quicker pain relief in patients of acute lumbago compared with diclofenac sodium alone. A randomized clinical trial. Surgical Department of C M H Attock. From September 2004 to August 2005. A total of 50 patients were selected for the study. The patients complaints were of acute lumbago of less than 3 days duration with severe impairments of movements. The age group of patients was between 20 and 65 years. The patients were randomly assigned into two groups. Group I was prescribed tablet diclofenac sodium 25mg along with vitamin B-complex containing combination of 100mg thiamine nitrate [B1], 100mg pyridoxine hydrochloride [B6], and 200mcg cyanocobalmine [B12] three times a day. Group II patients were prescribed 25mg of tablet diclofenac sodium alone. Improvement in the intensity of pain at rest and during movements [as assessed by the patients] was noted in accordance to visual analogue scale 1 to 10. The effectiveness of diclofenac sodium in combination with vitamin-B complex with diclofenac sodium alone was judged on the basis of extent of pain relief after 7 days of treatment. A total of 25 patients were treated with combination of diclofenac sodium and vitamin-B complex [Group I] and 25 were treated with diclofenac sodium alone [Group II]. As far as the extent of pain relief in first 7 days is considered, 22 patients [88%] belonging to group I and 10 patients [12%] belonging to group II had an excellent pain relief and were able to carry on with their normal routine activities. Remaining 3 patients in group I were completely relieved of pain in next 3 days while 15 patients in group II had to complete another 10 days for complete cure. To test the statistical significance of the result chi-square test was applied and the result showed that patients of Group I responded significantly well to the treatment as compared to those in Group II. Using the parameters of pain relief and movements of vertebral column, the combination of diclofenac sodium and vitamin-B complex was found to be more effective mode of treatment as the duration of treatment and the dosage of diclofenac sodium was less and also relief of pain was more rapid