Aetiological considerations of acquired aplastic anaemia

Acquired aplastic anaemia is one of the important causes of pancytopenia. This study was conducted to observe the mode of presentation of acquired aplastic anaemia and to find out its possible etiological factors. It is a hospital based descriptive study of 100 patients of acquired aplastic anaemia. Out of 100 patients 60 were male and 40 female. Majority [44%] of the patients were between 12-20 years of age. Patient presented with variable symptoms majority [40%] with fever. Most of the patients had haemoglobin levels between 4-6 gm/dl. [53%. Seventy percent of the cases had no obvious cause, while in 30% some known causative factors were found. Chloramphenicol was found to be the most common causative drug. Mortality was 35%. Thirty patients were partially treated and 15 were lost to follow up. Twenty patients showed improvement with treatment. Acquired aplastic anaemia is common among males and more prevalent in younger age group. It is idiopathic in 70% cases while 30% had some cause. It has very high mortality. Doctors need to keep in mind this fatal condition in patients presenting with anaemia and should properly investigate before prescribing antibiotics and haematinics

audit of inguinal hernia repairs - a PESSI experience

Inguinal hernia repair is the most commonly performed operation in general surgical practice. Advanced techniques like open and laparoscopic mesh repairs are the preferred operations these days. Social Security Health Care System working under PESSI [Punjab Employees Social Security Institute] provides a closed system of surveillance of operated patients. Patients once operated are on record and present for follow up to the relevant surgical unit for over a period of years, unlike the government hospitals, where patients are lost to follow up once they get discharged. Retrospective study. Department of Surgery, Punjab Employees Social Security Hospital, Ferozepur Road, Lahore from January 2001 to December, 2006. To establish the reliability of non-mesh tissue repair technique as a primary procedure in inguinal hernia. About 500 patients underwent surgery for inguinal hernias. In those with primary inguinal hernia, tissue repair techniques [plication of transversalis fascia and darning of posterior wall with prolene No.1] were used while in those patients who had recurrent inguinal hernias, either tissue repair or mesh repair was carried out. Tissue repair techniques gave us excellent results with a recurrence rate of 0.4% [2/500] over a mean follow up period of 4.5 years. The reliability of inguinal hernia repair technique primarily with a mesh is not established whereas the old traditional tissue repair techniques have decades of experience to justify their reliability as far as recurrence is concerned

Analysis of maternal complications in caesarean section

This interventional quasi experimental study was carried out at Gynaecology Department, Jinnah Hospital Lahore to determine frequency, indications of emergency and elective caesarean sections and to establish a comparison of maternal complications. During one year period July 2003-june 2004 total birth were 3932.955 women underwent caesarean section which makes the rate of 24.3% in our unit. Out of 955, 713[74.6%] were emergency and 242[25.4%] were elective caesarean sections. Common indications in emergency group were fetal distress [26.21%], repeat section [18.9%], failed progress of labour [14.3%] and malpresention [13%]. In elective group repeat section [48.7%], malpresentation [17.3%], cephalopelvic disproportion [10.8%] antepartum haemorrhage [8.3%] were common indications. 490[93.2%] patients in emergency group required blood transfusions mainly due to anemia and 36[6.8%] patients in elective group were transfused mainly due to placenta previa.54 women faced intraoperative complications.54[93.1%] belong to emergency group and 4[6.89%] belong to elective group. caesarean hysterectomy were done in 6 patients in emergency group. post operative complications were encountered in 162 patients.150[92.6%] were from emergency and 12[7.4%] were from elective group. Infective morbidity constituted the major post operative problem

Peripheral vascular trauma - A reeview of 50 cases

Vascular trauma has become a common surgical emergency now a days. Early identification, prompt -resuscitation and effective vascular repair are the mainstays in the limb salvage approach to these injuries. A review of 50 cases of vascular trauma cases parting from 1995 to 1997 in surgical emergencies of Mayo Hospital, Lahore. Fifty patients with peripheral arterial trauma were included out of which 14[28%] were blunt injuries and 36[72%] were penetrating injuries. Firearm penetrating injuries were the commonest 29[83%]. End-to-end anastomosis was the most common procedure employed for repair of vascular injuries 17[34%]. Failure rate in our series was 3[6%] resulting in limb loss