ABSTRACT
Objective: the purpose of this study is to present our experience of Laparoscopic Hernia repair
Material and Methods: we included 50 patients in our study. Total 67 Hernia repairs were done, 33 had unilateral hernia and 17 bilateral hernias. Mean age of patients was 45 years ranging from 20 to 73 years
Results: the operating time for bilateral hernia was 30% longer than unilateral, average time 67 minutes. As we got experience the operating time gradually reduced as it was evident from last 22[44%] patients, which had 35 minutes. Two [4%] of our patients had to be converted into open due to unavoidable complications. Minor complications like anterior wall cellulitis and seroma were managed conservatively with rest and antibiotics. There was no hernia recurrence in last part of our learning curve that is in last 30[60%] patients. Overall there were 2 [4 %] Recurrences occurred where the mesh was not anchored bytacs rather was fixed with polypropylene
Conclusion: laproscopic total extraperitoneal hernia repair offers the appropriate patient a viable alternative to open hernia surgery in terms of post-operative pain, recurrence and rehabilitation, to achieve good results, adequate cases should be performed to overcome the learning curve, and the mesh should be anchored to the inguinal floor to prevent recurrences
ABSTRACT
Objective: to assess the safety and complications of circumcision performed by plastibell technique
Material and Methods: a descriptive prospective study was done in a Khair-un-Nisa, an affi liated Hospital of FMH College of MedicineandDentistry Shadman Lahore. Data was collected from all the case done between January 2012 to December 2013. A total of 120 cases registered and results were analyzed to see the safety of procedure
Results: a total of 120 cases registered for the study. Mean age of neonates and infants was 14 +/-2 days. Circumcision was done with plastibell in all case. There was no major complication noted at operation time or at follow up. 13[%] cases developed minor complication like penile edema and redness. 5[%] got platibell slipped downward and 2 upward at shaft. In most case plastibell dropped at 5-7 days. 12 case plastibell dropped after 10 days
Conclusions: it is an easy, quick and safe technique. Outcome of this procedure is encouraging and there is no extra care needed for this procedure
ABSTRACT
Objective: to assess the role of Cecal Gurgling [CG] as a clinical sign to diagnose acute Appendicitis
Material and Methods: this study was conducted at the Allied teaching hospitals of FMH College of Medicine and Dentistry Shadman Lahore, between June 2011 and May 2013. Two hundred patients were included in the study between 13 and 50 years of age, presenting with pain right iliac fossa, irrespective of gender. All the patients were grouped according to the Alvarado scoring system into two groups; group I with score more than 7 and group II score less than 7, which was further subdivided onto CG positive and CG negative
Results: mean age of the patients was 18.5years [13-50]. 104 [52%] patients were male and 96 [48%] female. In Group I, 78 [93.97%] were confirmed to have acute appendicitis on histopathology [HP] and 5 [6.02%] were normal. In group II CG positive, 67 [95. 7%] patients were confirmed to have acute appendicitis on HP
Conclusion: we concluded from this study that CG is a good diagnostic sign in patients with borderline diagnosis and can be used in conjunction with Alvarado score to increase its yield. However, large randomized trial is required to strengthen this important clinical sign
ABSTRACT
Background: Carpal Tunnel Syndrome is the commonest peripheral neuropathy. It is caused by compression of the median nerve in the carpal tunnel in the hand. The objective was to evaluate the criteria of diagnosis and management of carpal tunnel syndrome. Department of Adult Surgery, FMH College of medicine and dentistry, Lahore
Material and Method: Twenty patients with Carpal Tunnel Syndrome were treated from July, 2003 to Dec. 2005 in the Department of Adult Surgery, FMH College of medicine and dentistry, Lahore during a period of 2 1/2 years
Results: Sex Incidence: Out of 20 patients 3 [15%] were men and 17 [85%] were women. The age range was from 22 to 65 years. The women were all housewives. The men were professional workers, working as carpenters, masons and factory workers. In one patient carpal tunnel syndrome was secondary to rheumatoid arthritis while in 3 patients diabetes was present. Forty patients presented with bilateral Carpal Tunnel Syndrome. History, examination and electrophysiological studies [EMG] established diagnosis. Ten patients were treated conservatively while 10 patients were operated. Open carpal tunnel release was done in all of these cases. One Patient developed tender hypertrophic scar while one patient developed recurrent Carpal Tunnel Syndrome for which he was re operated
Conclusion: The conclusion of our study is: The history, examination and electrophysiological studies are sufficient t to diagnose the carpal tunnel syndrome. Although MRI, CT scan and ultrasound are also available for helping the diagnosis. Many cases can be managed conservatively. Open carpal tunnel release is still the operative procedure of choice, endoscopic release is relatively a new procedure but it has its own limitations, merits and demerits