Sleeve gastrectomy

The aim of our work is to present Experience of Sleeve Gastrectomy at Centre of Bariatric Surgery of Dow University of Health Sciences. All patients were assessed multidisciplinary team before operation. Indications for LSG were BMI 35kg/m[2] with comorbidites and BMI >40kg/m[2] without comorbidities. Standard surgical technique adapted. Gastric division by a cutting stapler. The whole staple line was observed for bleeding and tested for leak. Total 10 patients were studied of which were four males and six females, Median age of was 40 years. Pre-operative median BMI was 52.2kg/m[2] [range from 46 to 61kg/ m[2]]. Median post-operative BMI of 9 months was 34.33kg/m[2] [range from 28 to 40]. Out of 10 patients, observed complications of bleeding was seen in one case and wound infection occurred in 2 cases. Considerable weight loss observed in LSG

Diathermy incisions v/s surgical scalpel incisions; outcome in general surgery

Objectives: The objective of this study was to compare the outcome of diathermy incisions v/s surgical scalpel incisions in general surgery

Study Design: Cross sectional study

Place and Duration of Study: This study was conducted at surgical unit 7, Sindh Govt. Lyari General Hospital and Dow University of Health Sciences between January to December 2009

Methodology: 100 consecutive patients for elective general surgery were randomly assigned to either group A incision with cutting diathermy [n=50] or group B cold steel scalpel [n=50]. Data including demographic details, hospital stay, infection rate and non-infective complications like swelling, bleeding, dehiscence and seroma formation were recorded in both groups to compare the final surgical outcome compared

Results: A total of 80 patients were included in the study, placed alternatively into two groups of 40 patients each with majority being male [n = 61, 76.3%]. The mean age was 22.46 years. The positive predictive value for patients of Group A was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basis of Gender for the two groups, the positive predictive value for male patients of Group A and B was 90.09% and 89.28% respectively, but for females the positive predictive value of Group A and B was 100% and 50% respectively. In Diathermy [Group A] total 20% patients developed complications and these were seroma formation [n=4, 8%], wound dehiscence [n=3, 6%] and wound infection [n=3, 6%]. In Scalpel [Group B] total 26% patients developed complications [P-value=0.370] in which seromas was noted [n=5, 10%] then wound infection [n=4, 8%], then wound bleeding [n=3, 6%] and lastly seroma formation [n=1, 2%]. Hospital stays were also almost similar with mean value 8.24 days in diathermy group and 10.54 days in scalpel group. No remarkable difference in demographics, characteristics and in other variables of patients was noted

Conclusion: We conclude that no significant difference in surgical outcome of both groups [cutting diathermy Vs. steel scalpel]. Therefore, use of either technique to create surgical wound merely depends upon preference of surgeon

Acute appendicitis; efficacy of complete clinical evaluation and modified Alvarado scoring system in diagnose

Objectives: the objective of this study was to compare the efficacy of Clinical Evaluation and modified Alvarado scoring system in diagnosing acute appendicitis

Study Design: cross sectional study

Place and Duration of Study: this study was conducted at Surgical Unit III of Civil Hospital Karachi from May 2010 to October 2010

Methodology: this study consisted of eighty patients. Patients were divided in two groups. Group A for complete clinical evaluation comprising of 40 patients and Group B for modified Alvarado scoring system comprising of 40 patients. Inclusion criteria were all patients presenting with RIF pain, nausea, vomiting, fever and/or anorexia, diagnosed as having acute appendicitis preoperatively and undergoing emergency appendectomy during this period, age >12 years and both gender. Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant female patients and those who did not give written consent

Results: a total of 80 patients were included in the study, placed alternatively into two groups of 40 patients each with majority being male [n = 61, 76.3%]. The mean age was 22.46 years. The positive predictive value for patients of Group A was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basis of Gender for the two groups, the positive predictive value for male patients of Group A and B was 90.09% and 89.28% respectively, but for females the positive predictive value of Group A and B was 100% and 50% respectively

Conclusion: we conclude that modified Alvarado score can be used safely and effectively in diagnosing acute appendicitis in adult males especially as the score increases from seven to nine

Frequency of thyroid cancer at King Fahad hospital, Madinah

To assess the frequency of common thyroid cancer at king Fahad Hospital, Madinah. Retrospective study. This study was carried out on all the patients treated for Cancer of Thyroid Gland, at King Fahad Hospital [KFH]-Madinah between Jan 2009 to February 2012. Ninety-one patients diagnosed with Cancer of Thyroid of various Age, Sex and Races were registered with King Fahad Hospital Madinah. 75% patients were Saudi nationals, 10% patients were from other Arab countries and the remaining 15% were non-Arabs. There were 72% females and 28% Males. The Ages ranged from 14 years to 94 years. 34% of these patients were less then 30 years of Age at the time of the diagnosis. Over 90% of the cases presented with Swelling Anterior Neck while in other 10% of the cases Dysphagia or Dyspnoea with Rt. or Lt. supraclavicular masss/swelling was the major complaint. 71% patients under went various surgical procedures for the Neck swelling. The Total Thyroidectomy was done in 48% patients. The Histology revealed 52% of pure Papillary Carcinoma and 23% were of Follicular origin. Majority of the diagnosed patients of Ca. Thyroid were referred to King Faisal Specialist Hospital Riyadh for Radioactive Iodine Ablation Therapy. The follow-up was poor as patients were from highly mobile population and belonged to Nine different countries. The study reveals that the presentation of Ca. Thyroid in our series is essentially similar to what has been reported from other parts of the world

To compare the frequency of superficial surgical site infection after laparoscopic versus open appendectomy

To compare the frequency of Superficial Surgical Site infection after laparoscopic versus open appendectomy. Randomized clinical trial study. This study was conducted at Surgical Department Jinnah Post Graduate Medical Centre Karachi and Dow University Hospital from August 2013 to January 2014. The source of data was patients admitted in emergency. Patients were selected on the basis of clinical features. The data was collected with the help of Performa attached. It included demographic data of the patient, presenting complaints, operative findings, Surgical site infection. Random patients were placed in two groups. Surgical site infection by observation of pain, redness, tenderness and purulent discharge from the wound. Patients included were of both gender and age above 13 years presented to emergency department diagnosed as acute appendicitis on the basis of history and examination and exclusion of under 12 years of age, appendicular mass, CLD, I.H.D, DM and renal failure. Out of 270 patients, 153[56.7%] patients were males and 117[43.3%] patients were female. In Present study the different operative findings with their distribution among gender are shown in table. In other findings three patients with ruptured ovarian cyst and one with Mackel's Diverticulitis in which procedure was converted to open and resection and anastomosis of small intestine was done. SSSI is found to associated with operative finding with a significant P value 0.001. Superficial Surgical Site Infection were observed in both procedure laparoscopic appendectomy allotted in 134 cases but four cases are converted to open procedure so they are excluded from the results. The reason for conversion in three cases was difficulty in mobilizing the appendix because of adhesion and in one case Mackel's Diverticulitis found which need open procedure for formal small intestine resection and anastomosis. Superficial Surgical Site Infection was observed in three cases of Laparoscopic appendectomy and in 15 cases of Open Appendectomy group with the P value 0.005. Laparoscopic appendectomy is a better choice because of its reduced frequency of SSSI when compared with open procedure. SSSI is an important complication

To determine the frequency of raised C-reactive protein in patients of acute pancreatitis

To determine the frequency of raised c-reactive protein in patients of acute pancreatitis. Cross sectional study. This study was conducted at Surgical Department Jinnah Post Graduate Medical Centre Karachi and Dow University Hospital from January 2013 to June 2014. The patients were selected on the basis of clinical features. Take detailed history regarding epigastric and upper abdomen pain. All the patients of either gender with acute abdominal pain presenting to emergency and diagnosed as acute pancreatitis by serum amylase of 1000 units or more were included in the study. Ranson Scoring and C reactive protein levels on admission were noted. A total of 144 patients, both males and females were included in the study. 17[11.80%] out of 144 subjects were males and rest were females 127[88.19%] cases. The minimum age was 25 years and maximum was 60 years but most of the patients were in the range of 40 to 55 years means age was 43 +/- 6.7 years. The minimum value was found to be 25 mg/L while maximum was 57 mg/L. Mean CRP was foud to be 32.2 +/- 11.43 mg/L for that group of patients. All the patients were also categorized as mild and moderate to severe on the basis of Ranson's criteria. 73% patients were found to have mild disease with rest having moderate to severe disease. Frequency of CRP observed in our study were in 139[96.52%] cases. We concluded that C reactive protein was a useful severity assessment marker in patients with acute pancreatitis and it can be proposed as an important single factor for determining severity of patients presenting with acute pancreatitis

Compare the complications of laparoscopic versus open appendectomy

To compare the complications of laparoscopic versus open appendectomy. Retrospective study. This study was conducted at Dow University Hospital from June 2012 to June 2014. Data was analyzed by reviewing patient records, patients bills records and patient discharge sheet. Each data was double checked and thoroughly supervised by author himself to assure quality and validation of the data collected. The information reviewed of patients with diagnosis of acute appendicitis included, age, sex, time taken for bowel function restoration, use of analgesia, postoperative stay and its clinical evaluation and confirmed by USG of abdomen requiring operation and total charges. Patients included who were operated in surgical unit I. Patients who were identified with associated gynecological disease, to be at high risk for general anaesthesia, had a past history of lower abdominal surgeries, appendicular abscess were excluded. Data was analyzed through SPSS software. 73 patients who underwent appendicectomy. Out of which 24 [32.87%] patients operated laparoscopically and 49 [67.12%] patients by open method. The mean age for open appendectomy was 26.53 +/- 12.3 years whereas, for laparoscopic appendectomy it was 29.9 +/- 13.3 years. Intraoperative findings were normal appendix 4[16.66%] in OA group and 2[4.08%] in LA group, Acute appendicitis 12[50%] in OA group and 31[63.26%] in LA group, Gangrenous appendicitis 3[12.5%] in OA group and [14.28%] in LA group, Appendiceal abscess 4[16.66%] in OA group and 5[10.20%] in LA group, Peritonitis 1[4.16%] in OA group and 3[6.12%] in LA group. Post operative complications were observed in both groups. Wound infection 5[20.83%] in OA group and 2[4.08%] in LA group, Intra-abdominal abscess 1[4.16%] in OA group and 1[2.04%] in LA group, Bowel obstruction 3[12.5%] in OA group and 2[4.08%] in LA group, Respiratory infection 2[8.33%] in OA group and 1[2.04%] in LA group. This retrospective comparative assessment indicates that the patient chart reduces the incidence of complications in LA was wound infection, intestinal damage, intra-abdominal abscesses, intestinal obstruction and respiratory infections

Bile duct injuries; frequency during cholecystectomy procedures either open or laparoscopic

To find out frequency of bile duct injuries during cholecystectomy procedures either open or laparoscopic.Prospective observational study. This study was conducted at Surgical department, Liaquat University Hospital Jamshoro and Dow International Hospital Karachi, from July 2012 to December 2013. This study consisted of hundred patients. Patients were divided in two groups. Group A for open cholecystectomy [OC] comprising of 50 patients who underwent elective open cholecystectomy. Group B for Laparoscopic cholecystectomy [LC] comprising of 50 patients who underwent elective Laparoscopic cholecystectomy. Inclusion criteria were all patients diagnosed case of gallstones on the basis of ultrasound abdomen, any age and both gender. Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant ladies due to risk of foetal loss, carcinoma of gall bladder, stone in CBD and obstructive jaundice. Out of 100 cases of gallstone were operated for either laparoscopic / open cholecystectmy. In open cholecystectomy group 20[40%] were male and 30[60%] female. Ratio male: female ratio of 1:1.5. In laparoscopic cholecystectomy group 11[22%] were male and 39[78%] female with male: female ratio of 1:3.5. There was wide variation of age ranging from a minimum of 10 year to 70 year in both group. The mean age was 41.28+12.30 years for OC group and 38.44+13.50 years for LC group [p 0.02]. Common bile duct injury were occurred 2[4%] patients in laparoscopic cholecystectomy group while 3[6%] patients observed in open cholecystectomy group. We conclude that found bile duct injury 2[4%] patients in laparoscopic cholecystectomy group while 3[6%] patients observed in open cholecystectomy group

Fast ultrasound; a basic tool to evaluate the blunt abdominal trauma patient and help to decision making for emergency surgery

Fast ultrasound is a basic tool to evaluate the blunt abdominal trauma patient and help to decision making for emergency surgery. Observational study. The King Fahad Hospital Madina Munawara, over a period between 2010 and 2011. This study consisted of 765 patients came in Emergency department The King Fahad Hospital Madina Munawara Level II, or Regional Resource Trauma Center Saudi Arabia. Detailed History was taken from all the patients with special regard to bland abdominal trauma. All patients were brought to a trauma resuscitation area where a trauma team conducted a primary survey, after an airway and adequate oxygenation/ventilation were established. The FAST examinations were performed using 4 windows: subxiphoid, right upper quadrant, left upper quadrant, and suprapubic. The critical areas for intra-abdominal bleeding were the hepatorenal space [Morrison's pouch], the spleno-renal space, and the pelvic pouch of Douglas. The FAST examinations were interpreted on the spot and results Recorded. Results were prepared with help of tables and graphs. Data was analyzed through SPSS software. 73 out of 765 patients who underwent FAST ultrasound in the Emergency Room. 40 [54.79%] cases were road traffic accident [RTA] injuries followed by injury due to fall were in 33[45.20%] cases. Findings are fast ultrasound observed 49 out of 73 patients [67.12%] were considered positive FAST who had fluid [blood] in the peritoneal cavity and these patients shift to Operative Room for surgery. While 24[32.87%] patients with no evidence of intraperitoneal fluid were considered negative for FAST and these patient underwent CT scans for evidence of solid organ injury[Chart No.2]. 5 out of 24 cases of solid visceral trauma found on CT scan abdomen, but had not been detected by FAST then shift to operative room after resuscitation. We conclude that FAST ultrasound is very helpful to assessment of blunt abdominal trauma and to detect intraabdominal fluid. Fast ultrasound can help in the quick decision for surgical intervention within minutes of a patient's arrival at emergency department

To evaluate the outcome of sacrococcygeal pilonidal sinus excision using karydakis technique

Objective: To evaluate the outcome of sacrococcygeal pilonidal sinus excision using karydakis technique. Study Design: Prospective case series study. Place and Duration of Study: This study was carried out in the Department of General Surgery Unit 111, Ward 26, Jinnah Post graduate Medical Centre, Karachi form March 2005 to Feb 201 2. Materials and Methods: The study included 85 consecutive patients who underwent pilonidal sinus excision by karydakis technique fulfilling the inclusion criteria. We excluded the cases of pilonidal abscess and the cases which came with acute infections. Patients under 12 years were also excluded. A prospective method of data collection was utilizes by filling in the proforma designed for the study. A complete record of the procedure, follow up was done initially on weekly basis for one month and then fortnightly for 6 months and subsequently monthly for 30 months. Results: Total of 85 patents were included in our study in which 68 [80%] were male and 17 [20%] were female. The mean age of the group was 30.56 years. All patients were followed postoperatively for 30 months. Mean hospital stay was 2.5 days. Majority 63[74.1%] of the patients underwent smoothly without major complication. In all 85 patients wound closed with prolene 210 interrupted sutures. In 9[10.6%] patients developed minor wound infection while 4[4.7%] patients develop wound dehiscence and 3[3.52%] patients develop recurrence. In all 85 patients prophylactic antibiotics amoxicillin + clavulanic acid 1.2gm was used. In infected patients accounting to a total of 13[15.3%], both major and minor infections were included and appropriate antibiotic was used as indicated in the culture and sensitivity report. Conclusion: Karydakis technique is superior to midline excision surgery. It is associated with significantly shorter complication rate, shorter hospital length of duration, rapid healing, cost effective, good cosmetic satisfaction, a high patient satisfaction rate and low rate of recurrence

Various presentation of abdominal tuberculosis in surgical patients

To see the various presentation of abdominal tuberculois in surgical patients. prospective study. This study was carried out in the Surgical Department at civil Hospital Karachi, from Oct 2011 to 31[st] May 2012. Study consisted of twenty six patients. Base line and specific investigations were done in all patients, especially mantoux test, sputum examination x-ray abdomen and ultrasound of abdomen. Inclusion criteria were that all patients diagnosed as case of tuberculosis on the basis of history, clinical examination and investigations. Exclusion criteria included unfit patients for general anesthesia, pregnant ladies due to risk of foetal loss, patients with carcinoma of colon. Data was analyzed through SPSS software. 26 cases of abdominal tuberculosis. 12 males [46.15%] and 14 females [53.84%]. Male to female ratio was 1:1.16. Age ranged from fifteen to seventy years with mean age of patients were 42.1 years. Twelve Patients [46.15%] presented in subacute intestinal obstruction, four patients [15.38%] with acute intestinal obstruction, six [23.07%] with signs of peritonism and four [15.38%] with mass in abdomen. Erythrocyte sedimentation was 2 patients [7.70%] had ESR 20 mm/hr, eight patients [30.77%] between 20 to 40 mm/hr, eleven patients [42.1%] between 40 to 60 mm/hr and five patients [19.23%] between 60 to 100 mm/hr. Liver Function Test was within normal range in all of them. Mantoux Test was found positive in fourteen [53.84%]. Plain x-ray abdomen erect and supine position showed sixteen patients [61.54%] significant findings were observed. Barium meal and Follow through examination was performed in four patients [15.38%]. Three patients [75%] showed narrowing of ileum and irregularities in the caecum and one' patient [25%] had dilated small bowel loops with narrowing of terminal part of ileum while caecum was normal. In one patient [3.84%] small bowel enema revealed delayed emptying of small bowel with dilatation of jejunum, Barium enema was performed in three cases, which revealed, filling defect in caecum and narrowing at ileocecal junction. We conclude that. The clinical features of this disease are usually non-specific, vague and diverse therefore the accurate diagnosis is some times difficult

Relationship between serum nitric oxide and sialic acid in coexisted diabetes, hypertension and nephropathy

This study was designed to study the relationship between serum nitric oxide and sialic acid in patients of diabetic nephropathy. Total 210 diabetic patients including 115 males and 95 females, suffering from diabetes and nephropathy [DN] were selected followed by informed consent and approval from institutional ethical committee. Equal number of age and sex matched normal healthy subjects were selected without any known history of hyperglycemia, hypertension and renal insufficiency as controls. Fasting blood samples from patients and controls were collected and analyzed for serum nitric oxide, sialic acid, fasting blood glucose [FBG], serum urea, creatinine, HbA1c and golmerular filtration rate [GFR]. The raised levels [p<0.05] of systolic and diastolic blood pressures, BMI, FBG, HbA1c, serum urea, creatinine and sialic acid were noted in DN patients as compared to controls. Significantly lower levels of GFR and serum nitric oxide [p<0.05] were observed in DN patients as compared to controls. Strong negative correlation was found between serum sialic acid and nitric oxide levels in patients diabetic nephropathy [p<0.05]. The relationship between the levels of serum nitric oxide and sialic acid may be considered as a strong biochemical indicator for micro and macro vascular complications of diabetes such as hypertension and nephropathy. These parameters should be taken into account during screening procedures regarding identifications of the diabetic patients to get them rid of progressive renal impairment to ESRD

comparison of disease caused by Shigella and Campylobacter species: 24 months community based surveillance in 4 slums of Karachi, Pakistan

Despite the efforts of the international community diarrheal diseases still pose a major threat to children in children less than five years of age. Bacterial diarrhea has also emerged as a public health concern due to the proliferation of drug resistant species in many parts of the world. There is a paucity of population-based data about the incidence of shigellosis and Campylobacter infections in Pakistan. We report country specific results for Shigella diarrhea that were derived from a multicenter study conducted in six Asian countries. Disease surveillance was conducted over a 24 month period in urban slums of Karachi, Pakistan, a city with a population of 59,584. Cases were detected through passive detection in study treatment centers. Stool specimens or rectal swabs were collected from all consenting patients. Between January 2002 and December 2003 10,540 enteric infection cases were detected. The incidence rate of treated diarrhea in children under 5 was 488/1000/year. In children, 5 years and older, the diarrhea rate was 22/1000/year. 576 [7%] Campylobacter isolates were detected. The pre-dominant Campylobacter species was C. jenuni with an increase of 29/1000 year in children under 5 years. Shigella species were isolated from 394 of 8032 children under 5 years of age. Shigella flexneri was the dominant species [10/1000/year in children under 5 years] followed by Shigella sonnei [3.9/1000/year], Shigella boydii [2.0/1000/year] and Shigella dysenteriae [1.3/1000/year]. Shigellosis and Campylobacter infection rates peaked during the second year of life. The incidence rate of shigellosis increased in old age but such a trend was not observed in Campylobacter infections. Of 394 shigellosis patients 123 [31%] presented with dysentery in contrast to only 54 [9%] of 576 patients with Campylobacter infections [p < 0.001]. Both Campylobacter infections and shigellosis are common in community settings of Pakistan but shigellosis presented more frequently with abdominal pain and dysentery than Campylobacter infections indicating that shigellosis may be a more severe illness than Campylobacter infections. Due to the increased and disease severity, drug resistant shigella have become a significant health problem; moreover it is a disease of poor and impoverished people who do not have the access to standard water and sanitary conditions, health care services or optimal treatment. In the face of these facts it is empirically important to develop a low cost effective vaccine that can protect these populations for a longer duration

Serum and salivary minerals in dental caries

Dental caries is a multifactor disease, affecting people of all ages. Inorganic mineral of serum and saliva can also have protective role in dental caries. This study was carried out to evaluate and compare the possible role of salivary and serum factors like pH, adequate level of calcium, phosphate and fluoride in dental caries. A Total of 100 subjects aged 10-40 were selected. Decayed, missed and filled teeth [DMFT] were used as indices for scoring the dental caries and were distributed or divided into 4 groups on the basis of DMFT indices as 4-8 [Group I], 9-16 [Group II], 17-24 [Group III] and more than 25 [Group IV], while the control subjects had DMFT index equal to or less than 3 BH, calcium phosphate, fluoride and lactic acid were analyzed in saliva and serum. Patients of dental caries showed significantly low levels of calcium, phosphate, fluoride [P<0.001] and significantly high level of lactic acid [P<0.001] in all the groups as compared to control subjects. Prominent significant changes were observed in different groups. The salivary and serum pH, calcium, fluoride, phosphate and lactic levels were found to be significantly changed among the patients having dental caries. It can be concluded from the findings of present study that the adequate levels of calcium, phosphate and fluoride in saliva as well as serum are responsible for the significant deposition of these minerals in plaque which greatly reduces the developmental caries in the adjacent enamel

Ionic and allied variations in normotensive and hypertensive diabetic patients

To investigate the disturbances of serum and red cell electrolytes in association with membrane Na[+]-K[+]- ATPase activity as well as the status of serum Urea, Creatinine and osmolality in normotensive diabetic and hypertensive diabetic patients. Thirty normotensive and thirty hypertensive patients [age and sex matched] were selected along with thirty control subjects. Erythrocytes were isolated from freshly drawn blood samples, washed and used for the estimation of sodium and potassium concentrations using flame photometer [Corning 410]. Erythrocyte membranes were prepared for the estimation of Na[+]-K+-ATPase activity in terms of inorganic phosphate released/mg protein/hour. Serum glucose, creatinine and urea were determined by well-documented ortho toulidine, Jaffe's and diacetyl monoxime methods respectively. Osmomat 030 was used to estimate the plasma osmolality. The intra-erythrocyte sodium, serum glucose, urea, creatinine and osmolality were increased significantly in hypertensive diabetic patients as compared to normotensive diabetic patients whereas Na+-K+-ATPase activity, serum sodium, potassium, magnesium and calcium were decreased significantly in hypertensive diabetic patients as compared to normotensive diabetic patients. Results confirmed that there is a significant difference between normotensive and hypertensive diabetic patients with respect to their electrolyte metabolism and associated pathways. These results will notably help the physicians to treat diabetic patients with associated morbidity like hypertension

Acute amphotericin-B induced nephrotoxicity in albino rats

Nephrotoxicity is one of the major problems encountered during treatment with amphotericin B which is a potent broad spectrum antifungal drug used in systemic and deep fungal infections. The present study was undertaken to investigate the acute effect on the morphology of renal parenchyma when drug is administered in nephrotoxic doses in albino rats. A total of 20 albino rats of either sex were taken and divided into two groups. Group A as control and Group B received a single dose [10 mg/Kg] of intraperitoneal amphotericin B. The animals were sacrificed and their kidneys were subjected to detailed histological examination. The morphological features observed in the kidney of these two groups were analyzed and compared. The animals receiving 10 mg/Kg amphotericin B as a single dose showed flattering of the tubular epithelial cells with loss of proximal tubular brush borders and accumulation of lymphocytes in the cortical interstitium as compared to control group. The number of the proximal tubules as well as the tubular cell nuclear count was also decreased significally. It is suggested that, amphotericin B induced damage to renal cortical tissues is due to free radical injury which later caused direct cytotoxicity to renal epithelium