Anterior cervical fixation with casper plate and locked screws in trauma patients - a study of thirty patients at Nishtar hospital, Multan

To analyze the results of anterior cervical fixation as regards the effective stabilization, immobilization and solid bony fusion in lower cervical spine injuries by the use of one Caspar plate attached with locked screws. This study was carried out in the Department of Neurosurgery, Nishtar Medical College and Hospital, Multan from May 2006 to May 2007. Thirty cases of cervical spine injuries ranging from 10 to 60 years of age excluding patients with firearm injuries, upper cervical spine [C1, C2] injuries and patients who were unfit for general anaesthesia due to associated medical diseases. Anterior cervical spine fixation was performed by Caspar plate attached with locked screws. Total patients studied were thirty in number. Males were 27 [90%] and females were 3 [10%]. 15 [50%] patients had history of fall from a height and out of these 14 [93%] patients nad history of fall from a tree. Most common level of fracture dislocation was C5-C6 inter space. The results showed the supremacy of anterior cervical fixation with Caspar plate and locked screws as regards effective stabilization, early mobilization and solid bony fusion. Anterior cervical fixation with Capsar plate and locked screws is the preferred treatment modality in lower cervical spine injuries

Microsurgical aneurysmal clipping based on computed tomography angiography

To evaluate the efficacy of Microsurgical Aneurysmal Clipping Based on the computerized tomographic angiography [CTA]. This study was carried out in Neurosurgery Department, Nishtar Hospital, Multan from June 2009 to December 2009. A total of 10 patients who were operated upon for craniotomy and clipping of the aneurysms. All the patients presented with spontaneous sub-arachanoid hemorrhage were worked up for the cause of their intracranial bleed. Computerized tomographic angiography was the initial investigation Patients with ruptured aneurysm wee considered for surgery. Ten patients were operated upon during a time span of six months and showed excellent compliance in their follow up visits. There was no mortality in any of the surgically operated cases. Only three [33.3%] patients suffered from minor morbidity which recovered in a short period of time with the steroids and physiotherapy. Preoperative angiographic studies were compared with the postoperative angiographic studies and the isolation of the aneurysm was assessed independently by a radiologist who was not the member of study team. CTA being a non invasive and quick method to visualize the angioarchitecture of the brain in an alternative method for the planning of the aneurismal surgery. The sensitivity of the CTA for the aneurysms of the brain in 80-85% with a specificity of 90-97% compared with the digital sub-traction angiography [DSA]

Hepatic lipoma

A 55 years old Saudi female presented with vague abdominal pain. Ultrasound showed 2.0 x 2.2 cm echogenic lesion in left lobe of liver as an incidental finding. CT upper abdomen, both unenhanced and enhanced, was done which showed non enhancing fatty lesion [Density 50 H.U.] suggestive of lipoma. Hepatic lipomas have no risk of degeneration; so only follow up ultrasound was suggested

outcome of stomach pull up in the benign and malignant diseases of the esophagus

The objective of the study was to assess the outcome of stomach pull up in benign and malignant diseases of esophagus. This study was conducted between January 1998 to January 2001, at Shaikh Zayed Hospital and Sir Ganga Ram Hospital, Lahore to evaluate the results of "Stomach pull-up" in benign and malignant diseases of esophagus. This study included twenty-five patients both males and females of different ages. Seven patients formed the benign group and eighteen patients in malignant group. Barium studies, gastroscopy and biopsy and C.T scan were important investigation other than the routine ones. We followed Orringer`s technique in most cases of [Stomach Pull-up]. Results of study were encouraging. The incidence of pneumothorax was 40% and anastomotic leak was 30% and mortality rate of 10% which were comparable to those reported in literature. We optimistically conclude from this study that stomach "pull up" is a safe and simple procedure and we recommend it as a curative and palliative procedure for benign and malignant diseases of esophagus