Association between helicobacter pylori eradication and weight gain

Background: Helicobacter Pylori is a common infection highly prevalent globally causing chronic gastritis, duodenal ulcer and gastric carcinoma. It is observed clinically that patients who underwent therapy for eradication of H Pylori developed weight gain. Objective of this study was to evaluate the association between weight gain and eradication of H pylori infection

Method: For this observational cross sectional study, 137 patients were studied after confirmation of diagnosis of H pylori. Base line data at the beginning of the study and comparison between pre- treatment and post treatment outcomes were assessed after 3 months of follow up

Result: After eradication therapy, a difference in body weight was evident from pre-treatment mean body weight of 61.7+/-12.3 kg to 62.5+/-11.2 Kg [P=0.011]. An increase in BMI was recorded from pretreatment BMI of 23.24 +/-2.1Kg/m[2] to 26.4+/-3.8 Kg/m[2] [P=0.028]. The assessment of symptoms was performed by applying Mann-Whitney U test of significance; score of symptoms showed a decline in intensity after eradication therapy. Mean score of dyspepsia decreased from 2.65 to 1.02 with a P value of 0.024, mean score of epigastric pain from 2.73 to 1.14 [P=0.041], mean upper abdomen fullness from 2.49 to 0.35[P=0.021]. A decrease in heart burn was noted 3.46 vs 0.92 [P=0.003] and loss of appetite was less severe; 2.89 vs 0.58 [P=0.011]

Conclusion: The eradication of H Pylori, after 3 months of treatment, is associated with mild weight gain

Oral submucosal fibrosis in rural sindh

OBJECTIVE: To determine the frequency of complications in Oral Submucus Fibrosis and to evaluate the major risk factors involved in OSF

STUDY TYPE: Observational Descriptive study

SETTING AND DURATION: Dr. Moula Bux Jaffery Memorial Hospital Badin, Sindh from January 2010 to September 2011

METHODOLOGY: Two hundred and eighty cases of OSF diagnosed on clinical base, detailed history and proper clinical examination of all the patients was conducted in ENT clinic and functional fibrosis grading system had applied in study, all the related information was documented on prescribed proforma

RESULTS: Majority of patients was related with more youthful age bunch with male prevalence

Most of the patients found 2nd and 3rd stage fibrosis. 99% patients had a history of taking Paan, CHHALIA and Gutka, 29% patients had developed recurrent mouth ulcers and 2% patient had developed neoplasia while 85% patients have history of recurrent throat infections

CONCLUSION: Major cause of OSF is use of Pan CHHALIA and Guttka. Young age group is more vulnerable. Recurrent throat infection is another burden over society

Salvadora persica; anti-inflammatory activity in rats

To evaluate anti-inflammatory activity of Salvadora persicain rats. The anti-inflammatory activity of Salvadora persica was assessed in 63 albino rats of both sexes, weighing 400 gm. They were divided into three groups, A [control], B [crude drug], C [standard drug] with twenty one animals. Each group was divided into three subgroups with seven animals. Groups B and C were given crude drug and aspirin diluted in one ml of distilled water once daily orally, in doses of 300, 500, and 700 mg/kg body weight respectively, prior to induction of edema and Group A was given same volume of saline. Inflammation was induced in hind paw of rat by sub-planter injection of 0.1ml of 1% carrageenan. Paw volume was measured in terms of milliliters using plethysmometer, immediately before injection and then hourly up to 5 hours and mean was calculated. The inhibition of edema was calculated for each subgroup with respect to control group. After carrageenan injection mean paw volume of control group was 5.43 ml, while that of drug treated subgroup was 4.32 ml and standard group was 4.49 ml at the dose of 700 mg/kg body weight. Comparison of crude drug with the control was found to be statistically significant only at 700 mg/kg and was comparable with the standard drug aspirin. Salvadora persica has shown anti-inflammatory activity by decreasing the paw volume of carageenan induced edema

Forehead flap for reconstruction of maxillofacial region defects

OBJECTIVES: To assess the efficacy and efficiency of forehead flap in reconstruction of maxillofacial region defects

STUDY DESIGN: Descriptive study

PLACE AND DURATION: Department of Oral and Maxillofacial Surgery King Edward Medical University/Mayo hospital Lahore, from November 2009 to June2012

METHODOLOGY: This study was carried out on 30 [Thirty] consecutive patients, of either sex, who required soft tissue reconstruction of maxillofacial region including oral cavity defects due to trauma, infection or after tumor ablative surgery. Follow up was done for four months and on every follow up visit, patients were questioned about the degree of satisfaction, with mouth opening and donor site aesthetics. Cosmetic deformity judged subjectively

RESULTS: The axial pattern fascio-cutaneous flap, for the reconstruction of maxillofacial region with oral cavity defect, performed in 30 patients. Success rate of the flap was 100%, with only partial necrosis of the flap in 1 case. Subjective assessment of the donor site however showed suboptimal results with 30% [n-9] patients moderately satisfied and 20% patients [n-6] were unsatisfied

CONCLUSION: Forehead flap is a reliable technique for reconstruction of maxillofacial region defects

Diagnostic value of needle-localization biopsy in the management of non-palpable breast lesions

To determine the diagnostic accuracy of needle localization biopsy in the management of non-palpable breast lesions. This study was conducted over period of two and a half year at surgery unit-II of SMBBMU and Larkana Medical Center. Total 51 patients were included who had BIRADS IV and V lesions on mammogram and ultrasound. All underwent wire/needle localization under ultrasound and latter diagnostic biopsy. All the 51 patients were females. The positive result in terms of presence of diseased breast tissue was found in 92.15%. Needle localization biopsy has good diagnostic accuracy. The results can be improved by bringing improvement in the field of interventional radiology

audit of informed consent in surgical patients at a university hospital

To obtain informed consent is considered an integral part of modern clinical practice. It works as a safeguard of patient's rights and minimizes the chances of legal action against the physician in case of any complication arising from the proposed therapy. Objective was to evaluate the practice of informed consent in patients undergoing surgery in a University hospital. A survey was conducted at different surgical departments of a university hospital during December 2007 to March 2008. Participants were selected from patients over the age of 18 years who had undergone elective or emergency surgery. All interviews were based on structured questionnaire. The patients were asked if an informed consent was taken or not before the surgery. They were also inquired if they were given information about the diagnosis, the surgical procedure planned and risks associated with it. The patients were also asked if they were informed about the types of anaesthesia proposed. A total of 106 patients were randomly selected for this study. In 8.5% cases, no consent was taken. Only 38% of the surveyed patients acknowledged that they actually understood the information imparted to them. 66% patients were informed about the type of anaesthesia proposed but none was given any hint about complications of anaesthesia. 11% patients actually signed the consent forms themselves. The quality of existing informed consent process in a university hospital is less than ideal. There is a great need to educate the doctors and healthcare regarding the importance of patient's autonomy and their right to the information about their medical condition and the proposed surgical procedures to ensure their participation in the decision making regarding their treatment

Early laparoscopic chdecystectomy

To assess the clinical outcome of laparoscopic Cholecystectomy for management of acute cholecystitis and to evaluate its safety, frequency of complications. Observational study. Surgical Units II and III of Chandka Medical College Hospital Larkana. From 01.09.2003 up to 31.12. 2007. A total of 100 consecutive cases of, acute cholecystitis confirmed subsequently by abdominal ultrasound scanning, who were admitted for early laparoscopic Cholecystectomy. There was female preponderance with male to Female ratio of 1:4.5. Mean age was 45.75, SD 11.99, and most of patients were received with in 24 hours from the onset of symptoms. In 51 patients ultrasound reveals Edematous GB in 24 [24%], Empyma 8[8%], Contracted 10[10%], Perforated 5[5%] and Gangrenous GB in 4[4%] while 49[49%] have acute cholecystitis with cholelithiasis. The conversion rate was 6%; The minimum time taken during the procedure was 50 minutes. No mortality was reported in this series. Emergency / early Cholecystectomy is reliable and safe modality cost effective, and timely surgery with modern conception in the management of acute cholecystitis, because of accelerated recovery, negligible wound infection or related complication, and less postoperative pain. So Lap Chole should be preferred technique now days for the treatment of acute cholecystitis at our Institute

experience of laparoscopic cholecystectomy

To document our experience of laparoscopic cholecysectomy. A case series. This study was carried out at private sector medical complex at Larkana. Duration: From 1st December 2002 to 31st May 2004 for a period of 18 months. Two hundred consecutive cases, suffering from symptomatic cholelithiasis, were admitted for laparoscopic cholecystectomy. Their case record was retrieved and analyzed. There was female preponderance with male to female ratio of 1:4.5. Mean age was 48 years. Majority of patients suffered from chronic cholecystitis. The conversion rate was 5% due to acute cholecystitis with friable adhesions, elderly patients with phlegmon, obscure anatomy and stones in CBD not detected on ultrasound. The mean hospital stay was 36 hows. No mortality occured in this series. Laparoscopic cholecystectomy is an effective and safe modality of treatment for symptomatic gall stones in experienced h and s. This technique was found to have distinct advantages such as shorter hospital stay, lesser postoperative pain and good cosmetic results

Ischiopagus tripus conjoined twins: a case report

Conjoined twins are one of the rarest congenital anomalies. We present a case of Ischiopagus tripus conjoined twins. The twins were fused at abdomen and pelvis, having two well formed lower limbs and one abnormal lower limb. There was only a single fused pelvis and only one set of well formed male external genitalia and absent anal opening. Anoplasty was done for imperforate anus and later on surgical separation attempted

Clinco pathological experience of gall bladder cancer in northern Sindh

Carcinoma gall bladder has a poor prognosis despite surgical resection of the tumour

-3 A prospective study was planned to evaluate carcinoma gall bladder according to its Clinicopathological presentation. Its frequency among gall bladder diseases was 5.21 percent with male to female ratio 1: 1.22. Average and median ages were 53.43 years and 55 years respectively. Peak age group was 5th decade. Three most common presenting complaints were right hypochondria! Pain [67.24 percent], vomiting [34.48 percent] and lump right hypochondrium [27.58 percent]. Most common macroscopic appearance was cauliflower like mass. Gall stones were associated with 39.65 percent cases. Most of the tumours were adenocarcinomas, majority in advanced histological grades. Glandular pattern was noticed in 27 cases and papillary pattern in 21 cases. Compared to developed countries our patients were more than a decade younger

Hypospadias repair: a five year experience

Ninety cases of hypospadias were operated in the Department of Paediatric Surgery, Chandka Medical College, Larkana, from January 1993 to December 1997. The most common age group was between 1-5 years [63.3%] and the most common variety of hypospadias was penile [68.8%]. Chordee was present in 76 patients [84.5%] and other associated anomalies were present in 8 patients [9%]. Family history of hypospadias was present in 3 patients [3.3%]. Patients without chordee were selected for single stage repair and those with chordee were selected for two stage Byar's method of repair. Chordee was corrected in 76 cases, out of which 37 patients are waiting for urethroplasty. Urethroplasty has been done in 53 patients; single stage urethroplasty in 16 patients and two stage Byar's urethroplasty in 37 patients. Overall complication rate of urethroplasty was 36%. Fistula was the most common complication [28.3%]. Byar's method of hypospadias repair was found most satisfactory and adaptable to all degrees of hypospadias

Profile of hyperlipidemia in patients of coronary artery disease

Data on 318 cases of coronary artery disease [Ischemic heart disease] was analysed to study the relationship between coronary artery disease and hyperlipidaemia and the ale and sex distribution of hyperlipidaemic patients. Serum lipid estimation was done on 246 males and 72 females. 111 cases [3-1.9%] were found to be hyperlipidaemic. 75.67% of these patients were males while 21.33%, were females. Peak-age incidence was in the 41 to 6O years age group which constitutes 67.54%. 45.04% had elevated serum cholestrol only [Type IIa] while 29.73% showed elevation of both serum cholestrol and serum triglycerides [Type IIb]. High demoity lipoprotein cholestrol was below 40 mg/ 100 ml in 18% of the cases

Orbital neurofibromatosis in Sindhi patients from Pakistan

Although its dramatic appearance makes neurofibromatosis of the eyelid and orbit a widely recognized entity, its occurrence without accompanying changes in the other areas of the body is rare. In a recent study of 750 space-occupying lesions of the orbit in Pakistani patients, only nine [1.2%] had neurofibromas. We report neurofibromatosis confined to the eyelid and orbit in two Sindhi patients from Pakistan, a 22-year-old man and a 24-year-old woman. The attempts at surgical intervention proved dismally discouraging in both cases