Results of Surgical treatment of Nonunion of Humeral Shaft Fracture with Dynamic Compression Plate and Cancellous Bone Grafting

Introduction: Nonunion of humeral fractures afterconservative or surgical treatment represents a disablingcondition for the patient and a challenge for the surgeon. Studyaimed to evaluate the outcome of treatment of humeral shaftnonunions with dynamic compression plate and cancellousbone graft.Material and Methods: This study was conducted atDepartment of Orthopaedics, GMC Srinagar from June 2016to December 2019. Twenty patients were operated over thisperiod. Trauma was the cause of injury in majority of thepatients. Nonunion was atrophic in 80% and hypertrophic in20% of the individuals. All the patients had closed fractureat presentation, and 70% had received previous treatmentfrom traditional bone setters and 30% had failure of theconservative cast management.Results: The average time to union was 18 weeks. Treatmentpreviously from traditional bone setters significantly affectedthe time to fracture union (p<0.05). All fractures unitedsuccessfully.Conclusion: we concluded that treatment with dynamiccompression plating and cancellous bone grafting remains aneffective treatment option for nonunion of humeral shaft.

Effect of cyclophosphamide on the microanatomy of liver of albino rats.

Background: Cyclophosphamide is widely used in the treatment of various neoplastic diseases and diseases associated with altered immunity. Higher doses used for longer duration effects many organs like urinary bladder, lungs, liver, heart and male reproductive organs. Methods: To study the effect of cyclophosphamide on the micro anatomy of liver, sixty eight Albino rats were taken and divided into three groups, group A (control group) of 20 animals, were fed with routine diet, group B (low dose group) of 24 animals, were given cyclophosphamide at the dose of 0.5 mg/100 gms in addition to the routine diet and group C (high dose group) of 24 animals, were given high dose of cyclophosphamide at the dose of 0.7 mg/100 gms of weight of animal in addition to the routine diet. The animals were sacrificed at intervals of 3, 6, 9 and 12 weeks, 5 microns sections of the tissue were prepared and stained with Haematoxylin and Eosin stain. Results: Microscopic changes in liver were apparent in the drug treated animals. In group B the changes appeared after 6 weeks while in group C they started appearing after 3 weeks of drug treatment. The changes were in the form of fatty changes, hemorrhages and central vein congestion. Conclusion: Cyclophosphamide induces histological changes like fatty infiltration and central vein congestion in the liver. These changes are with low doses given for longer durations and manifest earlier when larger doses are used. Thus it is advised that patients receiving cyclophosphamide should be periodically evaluated for liver dysfunction.

Therapeutic evaluation of a Unani herbo-mineral formulation in chronic urticaria

Chronic urticaria [Shara] often poses a therapeutic challenge. Alternative medicine, including herbal treatment is gaining popularity for the treatment of refractory skin diseases. To assess the safety and efficacy of a Unani herbo-mineral formulation in the management of chronic urticaria. The randomized, single-blind, placebo-controlled study was carried out at outpatient department of Medicine, National Institute of Unani Medicine Hospital, Bangalore, from 15th April, 2009 to 15th April, 2010. Diagnosed patients of chronic urticaria, qualifying the inclusion criteria, were enrolled in the clinical trial. The patients were divided randomly into test and control groups after obtaining their informed consents. Test group [20 patients] was administered a herbo-mineral formulation twice daily whereas control group [10 patients] were given placebo orally. The duration of this trial was 4 weeks and follow up was done weekly. The efficacy of the test drug was assessed by the total sign and symptom score [TSSS] and severity of itching, whealing and erythema. The test drug produced significant effect on itching, wheals, erythema and on TSSS without causing any untoward effect or adverse reactions as observed by the safety parameters. The herbo-mineral formulation can be used safely and effectively for the treatment of chronic urticaria

Congenital segmental dilatation of sigmoid colon, penile agenesis and umblical cord hernia: a new association

Congenital segmental dilatation of the colon, penile agenesis and umbilical cord hernia are individually rare congenital malformations. An association between all three malformations has not been previously reported. We report a neonate with congenital segmental dilatation of the colon, penile agenesis and umbilical cord hernia all coexistent in a new born

Preliminary results of laparoscopic assisted orchidopexy for intra-abdominal testis

To analyze the outcome Laparoscopic assisted Orchidopexy for Intra-abdominal Testis. A prospective, descriptive study from July 1997 to January 2007. The study was conducted in the Departments of Pediatric Surgery at Dow Medical College / Civil Hospital Karachi and National Institute of Child Health, besides some private hospitals of Karachi. All patients with impalpable testis. Patients with intra-abdominal testis were subjected to Laparoscopic assisted single stage or 2-stage Fowler-Stephens orchidopexy. All patients were reviewed two and six months after the procedure to assess the outcome of surgery. A total of 28 patients with 35 impalpable testes were seen during the study period. Of these 13 had impalpable testes on the right and eight on the left side, whereas seven were bilateral. Laparoscopic examination revealed 29 intra-abdominal testes. Amongst these, Laparoscopic assisted Single stage Orchidopexy was performed in four testes and the first stage of Fowler-Stephen Orchidopexy in 29 testes. Second stage of the Fowler-Stephens Orchidopexy was completed in 18 testes successfully, as we did not encounter testicular atrophy in any case so far. Postoperative complications were seen in two patients. One case developed port site haematoma which was drained and the other subcutaneous emphysema which was managed conservatively. Laparoscopic assisted single and 2-stage orchidopexy is a safe and successful treatment procedure for intra-abdominal testes

To determine the efficacy and safety of caudal bupivacaine in combination with rectal diclofenac for postoperative analgesia in paediatric patients

To assess the efficacy and safety of combination of caudal bupivacaine anesthesia and diclofenac sodium suppository for postoperative analgesia in pediatric patients. Interventional study. Imam Clinic [a private hospital] North Nazimabad Karachi. from May 2004 to March 2007. All pediatric patient ASA physical one and two between the ages 6 months to 12years of either sex undergoing infra umbilical surgery received caudal block with bupivacaine 0.25% in a dose of 0.5ml/Kg and diclofenac sodium suppository 1mg/Kg rectally. Patients in whom caudal analgesia was contra indicated or failed were excluded from the study. Postoperative pain was assessed using observers' pain scale and self report of pain by child when he was greater than 2 years age. Postoperative complications were also recorded. During the study period, 99 patients undergoing different infra umbilical procedures [hernia, hypospadias repair, PPV ligation, circumcision, orchidopexy etc] received combination of caudal bupivacaine analgesia and rectally administered diclofenac sodium for post- operative analgesia. There were 94 male patients. In all patients caudal block remained successful. All patients were pain free and none of them required additional/rescue analgesia. Postoperative nausea and vomiting were reported in 3 patients. No other side effects like retention of urine, respiratory depression etc was observed postoperatively. Combination of single shot caudal block with bupivacine 0.25% in a dose of 0.5 ml/Kg and rectal diclofenac sodium for postoperative analgesia in pediatric patient is a simple, safe and effective procedure

Laparoscopic surgery in children

To assess the efficacy and safety of various laparoscopic procedures in paediatric population. An analytical case series. Various public and private sectors hospitals of Karachi, from January 2001 to December 2006. Case records of all paediatric patients who underwent laparoscopy for diagnostic or therapeutic purposes were reviewed. Age, sex, investigations, preoperative diagnosis, per operative diagnosis, procedure, duration of operation, hospital stay and intra-operative and post-operative complications where recorded. Patients with impalpable testes were excluded from the study as they are reported in another study. During the study period, 19 paediatric patients underwent laparoscopy for different surgical conditions. Age ranged from 5 to 12 years. Eight patients were males and 11 females. Six patients underwent cholecystectomy for cholelithiasis. Investigations did not reveal any cause for cholelithiasis. Appendicectomy was performed in 7 cases. Two of them had interval appendicectomy, while five were operated for acute appendicitis. Out of 5, three had acute appendicitis while two had mesenteric lymphadenitis. Adhesiolysis was performed in five patients. Adhesions in four of them were due to tuberculosis, band, recurrent appendicitis and post-operative adhesions, while in fifth patient no cause could be ascertained. One patient underwent left varicocelecotmy. None of the patients required conversion to open surgery. There was no intra-operative complication while post-operative complications were minimal. We conclude that laparoscopic surgery is feasible, effective and safe in the management of a wide range of surgical conditions in children

Non high density lipoprotein cholesterol in type 2 diabetes mellitus

Dyslipidemia consisting of elevated triglyceride, decreased HDL, and low-density lipoproteins LDL particles of altered composition is an important cardiovascular disease [CVD] risk factor in individuals with type 2 diabetes mellitus. Measure of Non-HDL cholesterol might be a useful marker of this risk. Presuming the value of non-HDL cholesterol we intend to determine whether non-HDL cholesterol, a measure of total cholesterol minus HDL cholesterol is elevated in patients with type 2 diabetes mellitus. Study population comprised of 60 patients of type 2 diabetes mellitus [24 men, 36 women] from diabetic clinic Jinnah Postgraduate Medical Center Karachi. Each subject was interviewed, examined, and investigated for blood pressure measurements, body mass index, and fasting blood glucose. Blood sample was analyzed to determine serum total cholesterol and HDL cholesterol on auto analyzer after at least a 12-h overnight fast. The level of non-HDL cholesterol was elevated significantly [p<0.01] in hypertensive patients of type 2 diabetes in contrast to normotensive patients of same disease, while HDL cholesterol shows significant decrease [29.46 +/- 6.55] in hypertensive diabetics as compared to normotensive diabetics [34.43 +/- 9.44]. Non-HDL cholesterol was elevated in type 2 diabetics who suffering from hypertension

Urinary tract infection; an old disease in the new age

To document the common microorganisms causing UTI in human and their resistance to currently used antibiotics. PMRC, Research Center Khyber Medical College Peshawar. Retrospective analytical study. Jan 2000 to June 2003. Evaluation results of 597 urine cultures performed during the period, on clinically suspected referred subjects. Bacterial growth was obtained in 35% samples. Common micro organisms in decreasing order of yield are E. CoIi, Klebsiella, Staph aureus, Proteus species and pseudomonas isolated from 80, 7.1, 5. and 1.5% samples respectively. 100% sensitivity is observed for imipenum. Efficacy next in decreasing order was for Amikacin, Tarivid, Ciproxin and Rocephin. Esch. Coli is the predominant etiological organism of UTI and imipenum is the drug of choice to which over 80% of all the different organisms are sensitive. Constantly changing sensitivity pattern of the organisms responsible for UTI demands a periodic check for better selection of drug and reduction of consequences of the disease

Onlay island flap in the repair of mid and distal penile hpospadias without chordee

A prospective study was conducted on 13 patients with mid and distal penile hypospadias [without chordee] to study the out come of Onlay Island Flap repair in the Department of Paediatric Surgery of Dow Medical College and Civil Hospital Karachi from July 1997 to August 2003. Excellent cosmetic results were obtained in 12 patients. Only one patient developed urethrocutaneous fistula, which was successfully repaired. It is, therefore, concluded that the onlay island flap technique is a very good procedure for midpenile hypospadias without chordee and in patients with distal penile hypospadias with deficient ventral skin

Alstonia scholaris [L.] R. Br. A review on its chemistry and biological activities

Aistonia scholaris [L.] R. Br., locally known as Saitan ka jhad, is a traditional medicinal plant and is widely used by our traditional healers. The literature on the chemical constituents and the biological activities of A. scholaris bark, leaves, root, latex and flowers have been reviewed. Chemical studies show the presence of many compounds belonging mainly to the groups of alkaloids, glycosides, hydrocarbons and amino acids. Biological studies reveal significant antimalarial, anti-diarrhoeal, antifilarial, antileishmanial and protective effects against cell necrosis and inflammatory cell filtration and support the use of the leaves and bark in the folk medicine

Some marine drugs used in traditional medicine with special reference to avicenna's canon of medicine

Traditional uses of some marine, animal, plant and mineral drugs, mentioned in Greco-Arab system of medicine, have been described. "Canon of Medicine" [Avicenna, 980-1037 A.D.] provides the numerous traditional unique uses of the indigenous drugs from the sea. This review paper covers the literal translation of the 24 drugs of sea origin directly from the Arabic source for the first time. The drugs have been presented with English, Arabic and scientific names followed by important traditional uses from the Greco-Arab medical literature

Pharmacognosy of the bark of balanites aegyptiaca Del

The bark of Balanites aegyptiaca Del. is pungent, bitter and purgative; and considered to have anthelmintic properties. preparation of B. aegyptiaca is used against Bilharzia. Parasite. The paper deals with the macro and microscopic characters of the bark along with its physico-chemical standards, inorganic and organic analyses, determination of tannins and phenolic compounds and t.L.C. behaviour. Pharmacognostical standards of the drug are presented to help in the identification of genuine sample

survey of the medicinal plants of South Delhi: part III

The present paper enumerates 40 species belonging to 39 genera and 27 families with local names, various medicinal properties, habit, place of collection and frequency of occurrence from South Delhi area

Treatise on botanical, animal and mineral drugs for cancer

The knowledge of Sartan [cancer] in the Unani [Greco-Arab] system of medicine can be traced to ancient times [131-200 A.D.]. The knowledge of Abu Bakr Muhammad b. Zakariya al-Razi for curing of cancer is worth mentioning. Unani simples-plants, animals and minerals and formulations used for the treatment of the disease as mentioned by him have been presented scientifically. Numerous plant drugs have been tabulated with their correct botanical names, English names, part used and families. The claims have been reviewed in the light of research work conducted in India during the last three decades