Pharyngeal Pouch co-existing with Thyroid Mass: a rare presentation

A 60-year male presented with a 4-year history of a mass in the lower third of the neck, which had gradually increased in size. On initial examination, it was considered a thyroid mass. On detailed examination, another mass was found in the upper neck which was doughy in consistency and reducible in size. With available investigations, he was diagnosed as a thyroid mass associated with pharyngeal pouch. On exploration of the neck, the whole mass revealed to be a pharyngeal pouch. We have discussed the patho-physiology of the pharyngeal pouch and reviewed the literature in detail

Rubber band ligation vs injection sclerotherapy in office management of 1st and 2nd degree hemorrhoids

To compare the effectiveness and complications of Rubber Band Ligation [RBL] with Injection Sclerotherapy [IST] in the treatment of 1st degree and 2nd degree hemorrhoids. Randomized Controlled Trial. CMH Rawalpindi, from 1st Feb to 30 Sep 2007. A total of 120 patients were selected for study. 60 patients with 1st degree haemorrhoids were placed in group I and 60 patients with 2nd degree haemorrhoids were placed in group II. These patients were then randomly divided into two sub-groups 'A' and 'B' through Random Allocation by Table of Random Numbers. Group 'IA' had 30 patients of 1st degree haemorrhoids and group 'IIA' had 30 patients of 2nd degree haemorrhoids. Similarly group 'IB' had 30 patients of 1st degree haemorrhoids and group 'IIB' had 30 patients of 2nd degree haemorrhoids. Then groups 'IA' and 'IIA' were subjected to RBL and Groups 'IB' and 'IIB' were subjected to IST. The outcome measures were relief of symptoms, recurrence rate and complications. Male to female ratio was 11:1. Among patients subjected to RBL, 58.3% were from age group 2 [31-50 yrs] with mean age 42.90 +/- 11.74 yrs and mean duration of symptoms was 6.24 + 4.91 months. Among patients subjected to IST, 55% were from age group 2 [31-50 yrs] with mean age 45.62 +/- 12.49 yrs and mean duration of symptoms was 7.03 + 4.76 months. Important immediate complication was pain, but majority of patient were pain free. In group IA 36.7% patients had slippage of ligature but none of the patients undergoing IST developed Prostatitis. Visible bleeding was the main complication in group 'IA' 4th week [p < 0.05]. Response to IST among 1st degree haemorrhoids was significant at 4th week i.e. 90%, as compared to RBL, i.e. 63.3% [p <0.05]. IST is treatment of choice for 1st degree haemorrhoids, but for 2nd degree haemorrhoids, both RBL and IST are equally effective

Levosulpiride in premature ejaculation

Premature ejaculation is one of the most common sexual disorders. A large number of treatment options have been used so far for the treatment of this dysfunction and still a large number of experts are doing research in this field. Here we have tried to research on the beneficial effects of levosulpiride in the treatment of PE. Eighty-eight patients form different areas of Hazara division suffering from PE were chosen. Sixty-four patients were given levosulpiride and the remaining 24 patients were given Placebo. Out of 64 patients who have been given levosulpiride, 30 patients showed very good improvement, 14 patients showed some improvement, 14 patients showed little and 06 patients showed no improvement. levosulpiride have very good beneficial effects in the treatment of PE

Vesico-vaginal fistula: interposition flap, a key to success

Vesico-vaginal Fistula [VVF] is an abnormal communication between bladder and vagina that causes continuous discharge of urine into vaginal vault. The objective of this study is to describe current trends of aetiology and repair of Vesico-vaginal Fistulae. This is a Descriptive Study, conducted at Armed Forces Institute of Urology, Rawalpindi and Combined Military Hospital, Kharian between May 2001 and May 2007. All patients diagnosed as cases of vesico-vaginal fistulae were included in the study. Their demographic profile and repair success was determined. A total of 86 patients were included in the study. The mean age of the patients was 35.5 years [range 25-46]. Total abdominal hysterectomy was the most common cause [53% of the cases] followed by obstetric causes [43.92% of the cases]. Success rate of the surgery in the study was 97.5%. The common causes of vesico-vaginal fistula in this study were total abdominal hysterectomy and obstetric causes. The success rate was high, yet the attempt should be made to prevent this socially distressing condition