Intrapleural streptokinase in management of complicated parapneumonic effusion and empyema

We report our study of the use of intrapleural streptokinase [IPSK] in ten patients with multiloculated complicated parapneumonic effusion and empyema who had failure of conservative first line of treatment with antibiotics and intercostal tube drainage. In order to break the multiple loculi and facilitate tube drainage, we instilled intrapleurally streptokinase 250,000 units diluted in 100 ml of 0.9% saline. All our patients showed improved fluid drainage after IPSK. Five patients experienced clinical and radiological resolution. IPSK therapy was unsuccessful in the remaining five, who then underwent successful surgical intervention

Window [aslam-soomro] procedure for congenital Talipes Equino Varus

This prospective study, carried out in the Dept. of Orthopaedics at Civil Hospital Karachi, describes the results of our new technique i.e. the window procedure in the surgical management of Congenital Talipes Equino Varus [CTEV] of the mild and moderate type [Dimeglio Classification]. One hundred and thirty six patients, aged 6-18 months, were included in the study. Amongst them were 90[66%] boys and 46 [34%] girls. Out of the 136 patients treated with this new procedure, 15 were excluded from the study. Amongst the remaining 121 cases, 109 [90.08%] were functionally good. Nine [7.44%] patients had fair results and needed manipulation under general anaesthesia, while three [2.48%] were functionally poor. Amongst them two needed revision of Achilles tendon`s tenotomy while one needed revision surgery i.e. extended posterio-medial release. In view of good results and fewer complications, we advocate the use of this newer technique for CTEV of the mild to moderate type

Use of antibiotic beads in chronic osteomyelitis: six years experience at civil hospital, Karachi

This series includes 180 patients of Chronic Osteomyelitis who were treated with antibiotic beads from September 1995 to October 2001 in the Dept. of Orthopaedics at Civil Hospital, Karachi. Amongst them were 126 [70%] males and 54 [30%] females, with an age range of 12-52 years. They were followed -up for a minimum period of three years. One hundred and fifty three [85%] cases recovered fully with good functional result. In 18 [10%] patients the result of the treatment was fair as the patient ultimately recovered after initial problems, while in nine [5%] it was poor as the patients had to undergo another surgery. In view of good functional results, and fewer recurrences and complications, we advocate the use of antibiotic beads in the treatment of chronic osteomyelitis of long bones