Comparative efficacy of prolene and prolene-vicryl composite mesh for experimental ventral hernia repair in dogs

In this study, efficacy of two hernia mesh implants viz. conventional Prolene and a novel Prolene-Vicryl composite mesh was assessed for experimental ventral hernia repair in dogs. Twelve healthy mongrel dogs were selected and randomly divided into three groups, A, Band C [n=4]. In all groups, an experimental laparotomy was performed; thereafter, the posterior rectus sheath and peritoneum were sutured together, while, a 5 × 5 cm defect was created in the rectus muscle belly and anterior rectus sheath. For sublay hernioplasty, the hernia mesh [Prolene: group A; Prolene-Vicryl composite mesh: group B], was implanted over the posterior rectus sheath. In group C [control], mesh was not implanted; instead the laparotomy incision was closed after a herniorrhaphy. Postoperative pain, mesh shrinkage and adhesion formation were assessed as short term complications. Post-operatively, pain at surgical site was significantly less [P<0.001] in group B [composite mesh]; mesh shrinkage was also significantly less in group B [21.42%, P<0.05] than in group A [Prolene mesh shrinkage: 58.18%]. Group B [composite mesh] also depicted less than 25% adhesions [Mean +/- SE: 0.75 +/- 0.50 scores, P

Surgical site infection in lumbar surgeries, pre and postoperative antibiotics and length of stay: a case study

Postoperative wound infection also called as surgical site infection [SSI], is a troublesome complications of lumbar spine surgeries and they can be associated with serious morbidities, mortalities and increase resource utilization. With the improvement in diagnostic modalities, proper surgical techniques, antibiotic therapy and postoperative care, infectious complications can result in various compromises afterwards. The objective was to study the relation of surgical site infection in clean lumbar surgeries with the doses of antibiotics. This retrospective study was conducted at Shifa International Hospital, from January 2006 to March 2008. Hundred post operated cases of lumber disc prolapse, lumber stenosis or both studied retrospectively by tracing their operated data from hospital record section for the development of surgical site infection [SSI]. The patients were divided into three groups depending upon whether they received single, three or more than three doses of antibiotics respectively. Complete data analyses and cross tabulation done with SPSS version 16. Of 100 cases, only 6% had superficial surgical site infection; only 1 case with co morbidity of hypertension was detected. Twenty-one cases had single dose of antibiotic [Group-I], 59 cases had 3 doses [Group II] and 20 cases received multiple doses [Group III]. There was no infection in Group-I. Only one patient in Group-II and 5 patients in Group III developed superficial SSI. While 4 in Group-II, 3 in Group-III, and none of Group-I had >6 days length of stay [LOS]. The dose of antibiotic directly correlates with the surgical site infection in clean lumbar surgeries. When compared with multiple doses of antibiotics a single preoperative shot of antibiotic is equally effective for patients with SSI

Free radical oxidation of blood proteins in patients with diabetes mellitus and myocardial infarction

Oxidative Modification of Blood Proteins [OMBP] has been studied in 65 patients with Diabetes. Mellitus [DM] and Myocardial Infarction [MI]. It has been shown that both DM and MI patients have increased levels of OMBP as compared to healthy persons. Diabetic patients had significantly higher levels and slower dynamics of OMBP than non-diabetic patients did during 14 days after onset of Acute MI. These data suggest that Oxidative Modification of proteins is a possible factor contributing to the poorer outcome of MI in diabetic patients

Vaginal hysterectomy: study of 75 cases

To evaluate the outcomes of vaginal hysterectomy in respect of operative, post operative complications. Lady Aitchison Hospital affliated with king Edward medical college Lahore, from January 2004 to December 2005. Patients and methods. Out of total 215 hysterectomies performed, 75 were vaginal for different conditions. The results showed, that at the age of 50 yrs prolapse [48%] was the main indication, while menorrhagia [36%] was the main indication at age of 40 - 50 yrs. Between 30 - 40 yrs Menorragia with prolapse [16%] and below 30 yrs complete prodencia was the indication. 8% intraoperative complications were, 4% operative haemorrage, 1.3% visceral injury, 2.7% return to theature. The post operative complications were maternal death 1.3%, fistula formation [1.3%], return to theature [6.7%], retention of urine [5.3%], pelvic heamatoma [4%], and granulation tissue [2.7%]. In 80.1% of cases hospital stay was less than 72 hours Vaginal hysterectomy was the safest, low cost procedure in benign conditions with a few intra / post operative complications

Morphological and physico-chemical analysis of some anthelmintic drugs of repute

The diagnostic morphological and physico-chemical characters of five important anthelmintic drugs of the indigenous system have been studies on the basis of their morphological characters, ash and extractive values, chemical constituents and T.L.C. analysis

Experience of ureteric obstruction following ESWL and its management

One hundred consecutive patients with radiopaque renal stones size ranging between 5 to 35 mm were included. Prior to ESWL treatment double J ureteral stent was inserted in all patients [n=23] who had stone size over 20 mm to prevent risk of ureteric obstruction. Renal ultrasound and x ray KUB were required in every patient at each follow up to assess pulverization, steinstrasse and hydronephrosis. Overall ureteric obstruction due to steinstrasse was noted in 16 patients [16.0%]. The incidence of steinstrasse was 15/77[19.4%] when stone size was 5 to 20mm while it was 1/23 [4.3%] when stone size was above 20mm with double J ureteral stent in place. Adequate pulverization for clearance was 0% at the end of 4 months in the patients with stone size over 20mm. In 3 unstented patients ureteric obstruction was complicated with fever, nausea, vomiting and moderate to severe colic and hydronephrosis and uncomplicated in remaining 13 patients [1 stented and 12 unstented]. Double J ureteral stent was costly and associated with complications like frequency [34.8%], urgency [30.4%], lumber pain [39.1%], bladder pain [34.8%] fever [34.8%], burning micturition [8.7%], difficulty in walking [8.7%]. For complicated ureteric obstruction following ESWL in 5-20 mm size stones PCN and repeat ESWL is recommended in preference to double J stent wich is associated with a high morbidity. ESWL should not be offered to patients with stone size more than 20 mm.

Efficacy of extracorporeal shock wave lithotripsy [ESWL] in upper urinary tract calculi with reference to stone size radiodensity shape and site experience at mayo hospital Lahore

One hundred consecutive patients having renal or ureteral stones between 5-35 mm both radiopaque and radiolucent were selected. Stone size, radiodensity, shape, site, renal function, ureteral obstruction and any congenital renal anomaly were assessed by plain X-ray abdomen and intravenous urography. Stone density was considered low equal and high relative to that of bone. Shape was classified into round, oval, amorphous, partial staghorn and complete staghorn. At follow up, a plain X-ray abdomen and ultrasound was required from every patient to assess the pulverization, clearance of fragments and to decide the next session. At the end of four months ESWL treatment was considered successful if the patient was stone free or had residual fragments 4mm or less, determined by plain X-ray abdomen and ultrasound. Overall success rate was 54%, in renal stones it was 52.9% [45/85] in upper ureteral stones 62.5% [5/8] and in lower ureteral stones 57.1% [4/7]. Stones measuring 5-10mm, 11-15mm, 16-20mm and 21-35mm had success rates of 64% [32/50], 54.3% [19/35], 42.9% [3/7] and 0% [0/8] respectively. Equibone density, high density, low density and radiolucent stones had success rates of 56.1% [32/57], 10% [2/20], 94.7% [18/19], and 50% [2/4] respectively. Shapes of the stones is mere reflection of stone size. We conclude liberal use of ESWL for every type of stone in terms of radiodensity and size is not justified. Radiolucent stones or radiodensity equal to or less than bone and size upto 20mm were amenable to ESWL monotherapy