An unusual case of bilateral multiple ovarian dermoid cysts

Although the incidence of bilateral dermoid cysts varies from 10-15%, multiple ovarian mature cystic teratomas in the same ovary are very rare

A young 30 years old nulligravida, married for 5 years presented to our outdoor with intermittent pain hypogastrium for the last 3 months. The case was diagnosed on Ultrasonography to be bilateral multiple terratomas due to presence of hyper-echoic solid components in the cysts

On Laparotomy ovaries were conserved and three dermoid cysts were enucleated from both ovaries. Diagnosis was confirmed on hitopathology as dermoid cysts .Complete clearance of both ovaries at the time of excision of demoid is essential to nullify the risk of recurrence

Multiple volar dislocations of the carpometacarpal joints with an associated fracture of the first metacarpal base / 中华创伤杂志(英文版)

Multiple volar dislocations of carpometacarpal (CMC) joints are uncommon and have been reported rarely. A 25 years old male presented with injury to his left hand 6 days following a road traffic accident. Clinical examination revealed gross swelling of the hand and diffuse tenderness over the carpometacarpal area. His radiographs of the hand showed volar dislocation of the second, third and fourth CMC joints in association with an extra-articular fracture of the base of thumb metacarpal. He was treated by open reduction and percutaneous fixation using Kirschner wires. The functional results were excellent at one year follow-up.

Early versus late external cephalic version

To find out whether initiating external cephalic version [ECV] earlier in pregnancy increase the rate of successful ECV procedures, and be more effective in decreasing the non cephalic presentations at birth and also cesarean section rate. This interventional study was conducted in Department of Obstetrics and Gynecology Mardan Medical Complex from first July 2010 to 31[st] Dec 2011.It included women with singleton breech fetus at a gestational age of 34 to 35 weeks. Patients were randomly divided into two groups, those having a first ECV procedure between 34[238 days] and 35 weeks of gestation were called early ECV group the second group included those who had first ECV at or after 37 weeks[259 days] and were called delayed ECV group. Percentages were calculated for qualitative variables like Gravida, complications etc, while mean and SD for quantitative variables like gestational age. Out of total 203 women who had breech presentation 123 were finally selected for the trial. Early ECV group included 63 patients while delayed group included 60 patients.. Fewer fetuses were in non cephalic presentation at birth in the early ECV group [41/63[65%] versus 29/60[49%] in the delayed ECV group, p = 0.04. There were no differences in rates of cesarean section [19/63[30%] versus 20/60 [33%],p=0.42] in the early ECV group versus the delayed ECV group. The rate of preterm birth was not different between groups, early ECV group [2/63[3%] versus 0/60[o], p=o.26] delayed ECV group. External cephalic version at 34 and 35 weeks increase the likelihood of cephalic presentation at birth but it does not decrease the rate of cesarean sections and may increase the rate of preterm birth in the early ECV group

Disseminated cysticercosis incidentally diagnosed in a patient of low backache: a case report and concise review of literature

Disseminated cysticercosis is an uncommon presentation of a common disease. Asymptomatic disseminated cysticercosis is rarely reported in literature. Here, we are reporting a case of asymptomatic disseminated cysticercosis incidentally diagnosed in a patient of low backache. Magnetic resonance imaging of lumbosacral spine and neuroimaging done subsequently during the course of evaluation revealed diffuse cysticercosis involving abdominal, paraspinal, pelvic and gluteal muscles along with neurocysticercosis. Such a disseminated cysticercosis was diagnosed incidentally in this patient of low backache with right sciatica and radiculopathy at L5-S1 prolapsed intervertebral disc and was subsequently managed by L5-S1 interlaminar fenestration and discectomy.

Lithium toxicity

Background: Lithium is used for acute mania or prevention of the recurrences of bipolar manic-depressive illness in adults. There is a close relationship between toxicity and blood levels of sodium and potassium

Material and Methods: This study was carried out on 30 rabbits of mixed breed weighing 1 -2 kg. A lithium dose of 5mg/kg body weight/ day was given to rabbits for 22 days. Three blood samples were collected on 8th, 16th and 22nd days. Serum was separated and analyzed with flame photometer for lithium, sodium and potassium levels

Results: The level of serum lithium, sodium and potassium was significantly increased at 15th and 22nd day of administration of lithium carbonate

Conclusion: It is therefore concluded that concentration of lithium, sodium and potassium in serum must be determined. It is most important for family physicians who regularly treat patients receiving lithium as to how to monitor the safe use of drug

Effect of innate lipid solubility on buccal absorption of basic drugs

This study is designed, to find out the effect of innate lipid solubility on buccal absorption of basic drugs with similar pka values. Allopurinol hydrochloride, nortriptyline hydrochloride and procainamide hydrochloride with Pka values 9.4, 9.7 and 9.2 respectively were selected for in vivo [buccal absorption test] and in vitro [I-octanol/buffer partitioning coefficient] study at pH range 6-10. Results found that the mean percentage of buccal partitioning and/I-octanol partitioning of allopurinol hydrochloride was decreased with the increase in pH from 6.0-10. On the other had mean percentage of buccal partitioning and I-octanol partitioning of procainamide hydrochloride and nortriptyline hydrochloride was increased with the increase in pH from 6.010. It is concluded that although the drugs studied have nearly similar Pka values their lipid solubility is widely variable. A good correlation between buccal and I-octanol partitioning excluded the possibility of interaction between these drugs and I-octanol. Decrease in lipid solubility of allopurinol hydrochloride with increase in pH needs further evaluation

Effect of aspirin administration on serum lithium levels in rabbits

Effect of aspirin administration on serum lithium levels was studied at Fatima Jinnah Medical College, Lahore. 12 rabbits were divided equally into two groups and lithium was administered to one group while the other group received aspirin with lithium on body-weight basis for 22 days. Serum lithium levels were measured on the 7th, `15th, and 22nd day. Results showed a decrease in serum lithium upon administration of aspirin with lithium. We conclude that aspirin may be administered with lithium without any significantly adverse interaction or toxicity

Geographical/biochemical diversity of female breast cancer among developing and developed countries

A Prospective observational study was carried at Fatima Jinnah Medical College, Lahore on 100 female patients with histologically verified breast cancer and 50 age and sex matched control subjects with no history of breast cancer. The objective was to ascertain geographical/biochemical diversity of findings breast cancer among developed and developing countries. Physical findings as well as biochemical findings in serum of both patients and control subjects was carried out by standard automated calorimetric method. Variations in both physical findings and biochemical parameters was observed and compared with control subjects and with studies of different developed countries. It was concluded that seventy five percent of breast cancer in Pakistani women occurred with no recognized major risk factor. Further research is needed in the population of different city of Pakistan to find out the actual risk factor responsible for the disease

Effects of oral contraceptive therapy and its duration on the liver functions

Liver function tests were done in 75 females aged 20-40 year using oral contraceptives for 1-2-4 months and compared with 30 age matched controls. Use of any type of oral contraceptives either for 16 months [short term] or 6-24 months [long term], were associated with significantly higher levels of serum alkaline phosphatase, aspartate trasnaminase [AST], alanine transaminase [ALT], bilirubin and thymol turbidity as compared to controls. However. levels of these constituents of blood appear to be non-significantly different when compared among the two groups using oral contraceptives for short term and long. It is suggested that oral contraceptive drugs should be used with care and with proper investigation of the liver function before and during therapy