Comparison between double J [DJ] ureteral stenting and percutaneous nephrostomy [PCN] in obstructive uropathy

To compare the complications rate of percutaneous nephrostomy and double J ureteral stenting in the management of obstructive uropathy. Total number of 300 patients of age 20-80 years who underwent JJ stenting or percutaneous nephrostomy for obstructive uropathy were included in this study. Patients were divided in two groups i.e. A and B. In group A, 100 patients who underwent double J ureteral stenting while in group B, 200 patients who underwent percutaneous nephrostomy tube insertion were included. The stent was inserted retrograde by using cystoscope, under mild sedation or local anesthesia. While the percutaneous nephrostomy was done under ultrasound guidance by using local anesthetic agent. Complications were noted in immediate post-operative period and on follow up. Majority of the patients were between 36 to 50 years of age with male to female ratio was 2.6:1. The most common cause of obstructive uropathy was stone disease i.e. renal, ureteric or both. Post DJ stent, complications like painful trigon irritation, septicemia, haematuria and stent encrustation were seen in 12.0%, 7.0%, 10.0% and 5.0% patients respectively. On the other hand, post-PCN septicemia, bleeding and tube dislodgment or blockage was seen in 3.5%, 4.5% and 4.5% respectively. In this study, overall success rate for double J stenting was up to 83.0% and for percutaneous nephrostomy [PCN] was 92.0% [p < 0.0001]. Percutaneous nephrostomy is a safe and better method of temporary urinary diversion than double J stenting for management of obstructive uropathy with lower incidence of complications

Frequency of Hepatitis B, C and Human Immunodeficiency virus in blood donors at Shaikh Zayed Hospital, Lahore

To find out the frequency of hepatitis B, C and human immunodeficiency virus [HIV] in blood donors at Shaikh Zayed Hospital, Lahore. Design: This is a non-interventional study. Study Period: Period of this study is from 1-1-2005 to 30-6-2005. Study was conducted at the Blood Bank of Shaikh Zayed Hospital, Lahore. Subjects and Methods: In this study 18216 young healthy voluntary blood donors [age 16-50 years] comprising of 16611 males and 1605 females were included and tested for HBsAg, Anti-HCV and HIV by Accu check one step test [chromatographic immunoassay] in serum. Results: Frequency of hepatitis B, C and HIV infection was 3.36%, 4.16% and 0% respectively. We can get representative prevalence values of HBV, HCV and HIV infection in general population by collecting data from all blood transfusion centers of Pakistan. This is also helpful to create public awareness regarding hepatitis and HIV transmission through blood transfusion

Management of hilar malignant biliary strictures

To determine the etiology of Hilar malignant biliary strictures and the efficacy of hepaticojejunostomy in it's management with or without segmental liver resection. A retrospective study of 33 patients was carried out at Civil Hospital and Lyari General Hospital Karachi. They presented with signs and symptoms of mechanical cholestasis. Study was conducted to find the etiology, level of obstruction and the extent of the disease together with approaches to either cure the disease or to relieve the symptoms. Curative resection was attempted where possible in all 33 patients but decision of curative resection or palliative bypass with or without liver resection was made per operatively after accessing the level of obstruction and extent of local, parenchymal or vascular infiltration. Of the 33 patients studied, 72.73% [n=24] had cholangiocarcinoma and 27.27% [n=9] had gall bladder Ca with local bile duct extension. Four different sites of biliary tree [i] common hepatic duct [CHD], [ii] confluence of common hepatic duct [CCHD], [iii] right and left hepatic duct [R and LHD] separately, and [iv] left hepatic duct [LHD] were anastamosed with jejunum. Normal liver functions with complete relieve from symptoms was achieved where CHD or CCHD was anastamosed whereas only a significant decrease was observed when R and LHD and only LHD were anastamosed with jejunum. Surgical resection of the tumor together with biliary decompression using different approaches of hepaticojejunostomy is an effective way of managing malignant Hilar bile duct obstruction as well as significantly decreasing the severity of symptoms in irresectable tumours

outcome of darning method of inguinal hernia repair using polypropylene in a district general hospital

To evaluate the darning method of inguinal hernia repair with polypropylene.500 patients of unilateral inguinal hernia were admitted. After thorough investigations, all patients were operated for hernia repair by st and ard procedure using No.-l polypropylene. Patients were operated under local, spinal or general anaesthesia. Patients were followed up at one week, six weeks and six months after operation for wound healing and complications. Out of 500 patients, ranging in age from 20 to 70 years, 300 patients were given spinal anaesthesia, 100 patients [20%] were operated under local anaesthesia. 496 patients were discharged from the hospital on the following day. 3 patients went into urinary retention and one patient had large haemotoma requiring exploration. Recurrence rate was 0.8% [n=4]. Darning methods of inguinal hernia repair with polypropylene is a safe and cheaper method of hernia repair

Prevalence of malaria in general population of district Buner

To assess the prevalence of malaria in general population of Distt: Buner.From March to August 2001. Total of 1020 blood films from 40 different localities of Distt: Buner was randomly collected from both male and female of different age groups [1 to 70] and were analysed in 40 different localities of district Buner. Out of these, 70 individuals [6.86%] were positive for Plasmodium. The plasmodium species found were P.vivax [5.78%] and P.falciparum [1.08%] with not a single case of mixed infections. Incidence was higher among the male [7.10%] as compared to female [6.52%]. The higher rate of infections [11.58%] was found in age group 1-10 years and the lowest [5.19%] in age group 51-70 years. The highest rate of infections was recorded in August [11.66%] while the lowest rate of infection [3.98%] was noted in March. Slightly variation in prevalence of malaria was also observed in the four sectors A. B, C and D. The highest prevalence of infection [6.93%] was found in sector "C" where as me lowest [6 78%] was noted in sector "B". Malaria is a common health problem in Distt: Buner both P.vivax and P.falciparum exist. The higher rate of infection was found under the age of ten years [11.58%] and the maximum cases were noted in August [11.66%] while the lowest infection was noted in March the highest infection [6.93%] was founded in sector "C" where as the lowest infection [6.78%] was noted in sector "B"