ABSTRACT
To evaluate vascular injuries for the cause, site of injury, presentation and treatment. Descriptive study. Surgical unit I, Combined Military Hospital, Rawalpindi. Surgical Unit 2, Combined Military Hospital, Lahore. 1st August 2005 to 30th June 2010. All cases of missed vascular injuries [MVI] who presented to a single vascular surgeon, between 1st August 2005 and 30th June 2010 were examined in detail. Only cases with viable limbs and reversible ischaemia were included in the study. Patients with gangrene of the limbs of any extent were excluded. Record was made of the cause, site, mode of presentation and treatment. MVI was defined as vascular injury which was missed in the initial evaluation, operative procedure or intervention. Out of 41 cases, 31[75.6%] were due to gunshot or splinter injuries, 3[7.3%] external fixator injuries, 2[4.8%] carotid stentings, 2[4.8%] cardiac angiographies, 1[2.4%] fine needle biopsy, 1[2.4%] metallic rod penetrating injury and 1[2.4%] elective lumbar disc surgery. Neck was affected in 9[21.9%], upper limb in 7[17%] and lower limb in 25[60.9%] patients. There were 20[48.7%] false aneurysms, 8[19.5%] traumatic arteriovenous fistula [AVF], 5 [12.1%] false aneurysms with traumatic AVF, 3[7.3%] thrombosis, 1[2.4%] stenosis, 3[7.3%] hematoma and 1[2.4%] hemorrhagic shock. In 39[95.1%] cases surgical intervention was done. In 2[4.8%] cases, vascular injury was missed in polytrauma and mass casualty situation while 3[7.3%] cases were of polytrauma only. Penetrating trauma was the commonest cause of MVIs. Lower limbs were mostly affected. Most of the cases presented with pseudoaneurysms. Few cases had polytrauma/mass casualty situation at the time of initial presentation indicating that vascular injuries were missed either due to low index of suspicion by clinician or not following the proper protocol to avoid these injuries
ABSTRACT
Root canal treatment is an important treatment modality to restore the damaged or carious teeth so that the natural dentition can be preserved. Various indications of root canal treatment have been identified which have seriously insulted to the pulpal tissue and need early and effective treatment. Therefore it is very important to educate the patients and their relatives to prevent these factors. The main objective of this study was to to ascertain the frequency of different aetiological factors for the root canal treatment in 200 patients Descriptive study. At Operative Dentistry Department of Armed Forces Institute of Dentistry from January 2010 to July 2010. Total of 200 fulfilling the inclusion criteria reporting in OPD of Operative Dentistry: Department of AFID Rawalpindi were included in the study. A total of 200, 70 [35%] were females and 130 [65%] were males. The frequency of exposed teeth requiring root canal therapy in descending order were mandibular 1st Molar [19.5%], maxillary first molar [17.5%],maxillary second molar [13.5%], mandibular second molar [12.5%], mandibular second pre molar [9%], maxillary central incisors [8%], maxillary second premolar [6%], maxillary canine [4%], mandibular canine [3%], maxillary first premolar and lateral incisors [2.5%] each, and mandibular first premolar and lateral incisors [1%] each. Common indications for root canal therapy were necrotic pulp 47.5% involving 95 teeth, irreversible pulpitis 42.5% involving 85 teeth, trauma 6.5% involving 13 teeth, short obturation 2.5% involving 5 teeth and chronic hyperplastic pulpitis 1% involving 2 teeth. Necrotic pulp was the most common indication of initial RCT followed by irreversible pulpitis., while short obturation was the common indication of failed RCT
ABSTRACT
To assess the need for routine ureteral stenting after ureteroscopic lithotripsy. Prospective interventional study. Study was carried out between November 2006 to march 2009 at C.M.H Peshawar and C.M.H Lahore. A total of 100 patients were equally randomized into stented and non stented group. All these patients under went ureteroscopy and lithotripsy. The inclusion criteria was stone 6 to 10 mm. Those patients with large stones previous surgery or ESWL were excluded 8.9 Fr rigid ureteroscope was used with pneumatic lithotripter and 4.7 to 6 Fr double pigtail catheter was placed in stented group for 02 weeks. No ureteral dilator was used and stones were fragmented and no extraction device was used. A complete urine analysis x-ray KUB and USG were performed before and after operation in each patient. Pain score and lower urinary tract symptoms were recorded at the time of admission and three days after the operation. Regarding post operative pain no statistically significant difference was noted between the two groups [p <0.5]. The stone free rate was 100% with hydronephrosis resolved equally in both groups. 20 patients [40%] in stented group complained of at least two irritative bladder symptoms and only 05 patients [10%] in the non stented group experienced bladder discomfort. There was no significant difference in patients reported Haematuria in either group. Two patients in each group developed urinary tract infection. All those patients who were without a stent after uncomplicated ureteroscopic lithotripsy have similar renal function recovery and satisfactory pain reduction and with less irritative symptoms as compared to those with stent. We suggest that it is not necessary to place a ureteral stent in every case after ureteroscopic lithotripsy for stones smaller than 01 cm