HRCT of pituitary fossa correlation of clinical and CT findings

Purpose of the study was to correlate the clinical features with HRCT [High Resolution Computed Tomography] findings of pituitary fossa. Findings in a series of 30 patients, [22 female and 8 male] who underwent CT scanning of the pituitary fossa are reported majority of them had clinical suspicion of prolactinoma rest have other clinical signs of pituitary disease. Results showed 13 [out of 22] female patients with positive scan and 4 [out of 8] male patients with positive scan. In conclusion, this study conforms the usefulness of high resolution CT scanning of the sellar region in a specific settings

Metronidazole for bacterial vaginosis - a comparison between vaginal gel and oral therapy

To compare the efficacy of 0.75% metronidazole vaginal gel with oral metronidazole for the treatment of bacterial vaginosis. Comparative study, conducted in the Department of Obstetrics and Gynaecology at Ghurki Trust Teaching Hospital attached with Lahore Medical and Dental College, Lahore. The total number of patients included were 290. They were divided into two groups, by random selection. Group A [150 patients] and Group B [140 patients]. 150 patients received metronidazole vaginal gel for 5 days. 98 [85%] patients were free of signs of infection. 11 [9.5%] patients showed partial response and the dose was repeated, while 6 [5.2%] patients showed no response to treatment. 140 patients received metronidazole 400 mg x BD orally for 5 days. In which 80 [77%] patients were free of discharge while 14 [13%] patients and 10 [9.6%] patients showed partial or no response respectively and it was mainly because of gastro-intestinal complaints. Vaginal metronidazole is effective for the treatment of bacterial vaginosis and is associated with better compliance and less side effects as compared to oral metronidazole

Hysteroscopy - 3 Years experience at a Teaching Hospital

To evaluate the indications, effectiveness and safety of hysteroscopy in Gynaecological surgery. Design, A retrospective observational study from January 2003 to December 2005 at Fatima Memorial Hospital, Lahore. 76 patients who presented in the outpatient department of Gynae and Obstetrics at Fatima Memorial Hospital, Lahore with the following complaints including abnormal uterine bleeding, infertility, recurrent abortions and secondary amenorrhea were included in the study. They were pre-operatively investigated and admitted a day prior to the surgery and discharged usually within 24 hours postoperatively. The subsequent follow-up was done in outpatient department. All the data was recorded and then subsequently analyzed. 76 patients were inducted in the study. Out of these 36 [47%] had infertility 20 [26.3%] had abnormal uterine bleeding, 8 patients [10.5%] had recurrent abortions, 8 [10.5%] presented with secondary amenorrhea, 3 patients [3.9%] presented with lost IUCD and one patient [l.3%] had follow-up hysteroscopy after resection of intra- uterine septum. Hysteroscopic findings revealed intra-uterine adhesions in 8 [10.5%], submucous fibroids in 15 [19.7%], endometrial polyp in 10 [13.l%] uterine septa in 8 [10.5%], atrophic endometrium in 9 [11.8%] while there was no abnormal finding in 26 [34.2%] patients. Two patients [0.6%] sustained uterine perforations, which were diagnosed and managed during operation but no other complication occurred. Hysteroscopy is an excellent tool to perform intra-uterine adhesiolysis, polypectomy, submucous myomectomy and endometrial ablation. In addition to being a quicker, less invasive and low risk procedure, it has got the advantage of being cheap with a shorter hospital stay and diminished recovery time. Hysteroscopy, both diagnostic and operative should be an integral part of gynaecological surgery in the teaching units

Pseudomyxoma Peritonei - a rare abdominal tumor

Pseudomyxoma peritonei is a rare abdominal tumor with a reported incidence of approximately 1 per million per year. It is invariably fatal as the space within the abdomen is eventually replaced by mucinous tumor. We report one case of Pseudomyxoma peritonei

Comparison of snod gross and para-meatal based flap technique for hypospadiasis

To compare the two surgical procedures Snod gross and parameatal based flap technique for mid and distal penile hypospadias including cosmosis. Randomized Clinical interventional trail. This study was conducted in the Urology Department of Assir Central University Hospital ABHA, KSA and Department of Urology and Renal transplantation, Jinnah Hospital, Lahore from June 2002 to Dec 2004. Thirty-two patients were selected for this randomized clinical intervention study with mid shaft and distal hypospadias fulfilling the inclusion criteria. Snod Gross and parameatal based flap technique was assigned randomly to patients comprising of two groups of sixteen each. Watertight closure was made with 6/0 vicryl. Tourniquet or 1:10000 epinephrine were used. Follow up at 2 weeks, three months; 6 months post catheter or stent removal and the patient were assessed on criteria of cosmosis, time for surgery and complications associated with the procedure. Thirty-two patients who underwent procedure of Snodgross and parameatal-based flap in the management of mid shaft and distal penile Hypospadias. Age ranged from 2-12 years. The mean age was 5.23+4 years. The presentation of patients was dystocia of external meatus with misdirected stream in sixteen [50%] patients, spraying of urine in six [25%] and narrow stream in 4[13%] patients. Eighteen patients were having distal penile and fourteen were having mid shaft hypospadias. Following Snod grass technique all patients had good cosmetic results without any complication. Following parameatal based flap, one patients [6.3%] develop wound dehiscence, three patients [18.8%] develop urethral fistula, two patients [12.5%] showed metal retrieval and twenty patients showed good cosmosis. In our study, comparison between Snodgross and parameatal-based flap, the success rate was 100% and 62.4% respectively. Success with Snod gross procedure is better with no complications and good cosmosis. Complications rate was 37.6% in-patient with para-meatal technique

Maternal and fetal complications in multiple pregnancies

To analyze the feto-maternal complication in multiple pregnancy and strategy for its prevention and treatment. Descriptive study. This study was carried out at DHQ Hospital, Faisalabad over a period of one year from December 2004 to December 2005. There were 60 cases of multiple pregnancies out of a total 3000 pregnant women. Patients with multiple gestations were referred from emergency as well as from outpatient department to labor room and out come and any associated complications were recorded. During one year study period there were 60 cases of multiple pregnancy. Most of multiple pregnancies [91%] were spontaneous. 96% patients were carrying twin pregnancies while 2 cases [3.3%] of triplet pregnancies were recorded. Recorded maternofetal complications of multiple pregnancies were miscarriage [5%], preterm delivery [33.3%], pregnancy induced hypertension, pre-eclampsia, eclampsia [33.3%], intrauterine growth restriction [16.6%], intrauterine death [6.6%] and postpartum haemorrhage [6%]. 35% delivered vaginally while 41.6% were delivered by ceasarean section. Multiple pregnancies are high risk pregnancies with associated feto-maternal morbidity and mortality due to accompanying complications. Chances of a successful outcome may be improved by appropriate preventive, diagnostic and management strategies, by the availability of specific skill and experience and by a multi-disciplinary approach

Influence of water stress and exogenous glycinebetaine on sunflower achene weight and oil percentage

The study was carried out to assess whether exogenously applied glycinebtaine has any role in reducing the adverse effects of water stress on sunflower achene yield and oil contents. Two sunflower lines, Gulshan-98 and Suncross were subjected to water stress at the vegetative and reproductive stages of plant growth. Three levels of glycinebtaine [0, 50 and 100 mM] were applied before sowing [seed treatment] and at the time of initiation of stress at the vegetative and reproductive stages. A marked adverse effect of water stress on 100-achene weight and achene oil contents were observed in both sunflower lines. Exogenous supply of glycinebtaine was not effective in alleviating the adverse effects of water stress on achene oil percentage. Foliar spray of glycinebtaine, however, significantly reduced the negative effects of water stress on achene weight. Seed treatment with either level of glycinebtaine was not effective in increasing the 100- achene weight and achene oil percentage under both normally irrigated and water stress conditions. The sunflower line, Suncross produced higher oil yield than that of Gulshan-98

Transuretheral resection of prostate [TURP] - a treatment modality for benign prostatic hyperplasia [BPH]

This prospective study was done to know the complications of TURP as a treatment modality for BPH. 1200 patients having TURP at Jinnah and Mayo Hospital, Lahore from 1996 to 2002 were included. All the patients were evaluated by history, examination and investigations. Age range included from 45 to 115 years. Retention of urine was commonest indication for the procedure followed by raised prostatic symptom score. Seventy-two% patients had prostate size between 31 to 50 gram on DRE and Ultrasonography. Hypertension, DM and pulmonary diseases were common comorbid conditions in these patients. In early complication clot retention in 8% and ITTI in 7.6%, and failure to void in 4.7%. In the late complication stricture 6%, impotence 2.3% and incontinence 0.5%. Histopathology detected carcinoma of the prostate in 6% patients

Diagnosis and management of uric acid nephrolithiasis

The aim is to provide an account of the diagnosis and management of uric acid stones. Material and methods: A search was made on the topic of uric acid stones with regard to the diagnosis and management of uric acid stones. The incidence of uric acid stones varies between countries and account for 5% to 40% of all urinary calculi. Uric acid stone cannot be seen on x-ray. Intra venous uroghraphy, CT scan or sonoghraphy is required for their diagnosis. This is the only stone that can be reliably dissolved by urinary alkalization with alkali [Bicarbonates, citrate]. This medical treatment is highly effective resulting in dissolution of existing stones and prevention of stones. Extracorporeal shock wave lithotripsy and percutaneous nephrolithotripsy can be used successfully for uric acid stones. Open surgery is still performed especially for large complicated staghorn stones. Medical management with urinary alkalization for uric acid stone dissolution and prevention of recurrence is effective

laboratory study of susceptibility of methicillin resistant staphylococcus aureus [MRSA]

To study the mode of infection, incidence of Methicillin resistant Staphylococcus aureus [MRSA] and their susceptibility against glycopeptides and Fucidic acid, so that awareness may be created for consultants against such notorious rapidly spreading bacteria and recommendation can be made for their prevention and control. Design: 350 S.aureus Strains were isolated from 1800 random clinical specimens. 135 MRSA out of these cultures were selected for determining susceptibility to Vancomycin, Teicoplanin 13 Fucidic acid. Place and Duration: The samples were processed in the Department of Pathology, King Edward Medical College, Lahore, during June 2000 to December 2000. The specimens from various infections suspected on clinical ground were processed by Standard methods and antibiotic susceptibility testing of all the 350 S.aureus and 135 MRSA isolates was done by using modified Kirby Bauer Disc diffusion technique. Result: Of 350 positive S.aureus cultures, 135 were found to be Methicillin resistant [38.5%] which showed susceptibility 96%, 94% and 86% to Vancomycin, Teicoplanin and Fucidic acid respectively. This study showed a high incidence of MRSA at Mayo Hospital Lahore. Glycopeptides and Fucidic acid were found to be valuable antibiotics against MRSA

role of garlic powder and gemfibrozil in lowering lipid levels in patients of diabetes mellitus

To study the effects of powdered garlic [Allium sativum] on the lipid profile of patients of diabetes mellitus with hyperlipedemia. DESIGN: Controlled trial. PATIENTS AND METHODS: Ten patients fasting serum cholesterol levels of 280 mg/ 100 ml or more and /or triglyceride 180 mg / 100 ml or more were treated with powdered garlic at a dose of 6 grams/ day for four weeks. Gemfibrozil 1200 mg/day was used on seven patients for 4 weeks as standard drug for comparison. The data obtained showed a marked reduction in total serum lipids, cholesterol, triglycerides and LDL- Cholesterol levels while mean serum HDL - Cholesterol levels were significantly raised which was more marked with garlic as compared to gemfibrozil, CONCLUSIONS: Garlic power has got significant effect on lowering most of the serum lipids. HDL- C levels were raised with its use. In diabetic patients the beneficial effects of garlic powder are significant and economical

Effect of garlic [Allium Sativum] powder on lipid profile in patients of ischemic heart disease [IHD]

The effects of garlic [Allium Sativum] powder were studied on the lipid profile in patients of ischemic heart disease [I.H.D] and compared with gemfibrozil [Lopid], a standard lipid lowering agent. Twenty one patients of I.H.D. with raised lipid levels were administered 6 grams of garlic powder, in three divided doses, orally for four weeks. Seven patients of I.H.D. with raised lipid levels were given 1200 mg gemfibrozil orally per day in two doses for four weeks. Garlic powder reduced serum total lipids, cholesterol, triglycerides and LDL-C more than gemfibrozil but the differences were non-significant [P>0.05]. Garlic powder increased the level of HDL-C more than gemfibrozil and the difference was significant [p<0.01]. No side effect specifically comparing with gemfibrozil was detected in the patients treated with garlic

Comparative study of garlic powder and gemfibrozil in patients of ischemic heart disease and diabetes mellitus

In this study we observed the effects of garlic [Allium sativum] powder on lipid profile in hyperlipidaemic patients [fasting serum cholesterol 280 mg / 100 ml or more and / or triglyceride 180 mg / 100ml or more] suffering from ischemic heart disease [IHD] and diabetes mellitus [DM] and compared its effects with those of the standard lipid regulating drug gemfibrozil [Lopid]. Nine patients suffering from IHD and DM were put on garlic powder [6 gram / day] for a period of four weeks, six patients were put on gemfibrozil [1200 mg/day] for a period of four weeks. After completion of the treatment the lipid profile was again examined. The parameters studied were serum total lipids, cholesterol, triglyceride, low density lipoprotein- cholesterol [LDL-C] and high density lipoprotein-cholesterol [HDL-C]. The reduction in the garlic treated group of patients of serum total lipids, cholesterol, triglyceride and LDL-C was more marked as compared the gemfibrozil treated patients. Garlic increased the mean serum HDL-C levels very significantly. All these changes produced by garlic powder are beneficial in patients of IHD and DM which are at high risk. Serum total lipids, cholesterol, triglycerides and LDL-C directly or indirectly enhance the process of atherosclerosis, while HDL-C slows this process by taking away cholesterol from arteries towards the liver for its metabolism and excretion. So garlic is very useful dietary component for slowing the process of atherosclerosis and its associated complications in high risk patients if used regularly for a long time