Varicocelectomy high ligation versus low ligation

To find out the outcome of two modalities in management of varicocele comparing high ligation [Paloma's procedure] and low ligation [Ivanissivich's procedure] This observational descriptive study was carried out in Surgical units of People's Medical College Hospital Nawabshah on 60 patients, belonging to age group of 15 to 36 years from January 2002 to December 2006. Patients with varicocele were divided in two groups of treatment modality equally. Group I comprising 30 patients for high ligation whereas 30 patients were kept in Group II for low ligation. Follow up was carried out for two years but response was poor. Varicocele had been observed on left side in most of the cases [95%]. Three cases [5%] presented in Grade-I, 21 [35%] in Grade-II and 36 [60%] in Grade-III varicoceles. Oligospermia was detected in 15% of cases. Group I patients were apprehensive regarding disappearance of dilatation and hanging veins postoperatively seen in 70% of cases whereas disappearance of veins were seen in 93.34% in Group II patients. Complications like haematoma and hydrocele are seen in Group II patients as compared to Group I. Wound infection and recurrence remained almost the same in both groups. High ligation was better tolerated with less complication but did require more counseling regarding disappearance of dilated veins. Paloma's procedure also does not disturb the normal anatomy of inguinal canal

Otolaryngologic manifestations of gastroesophageal reflux disease

To determine frequency of endoscopic oesophagitis in the patients who complain the chronic laryngopharyngeal disorders in the absence of typical gastroesophageal Reflux Disease [GERD] symptoms. Descriptive study The study was carried out in the department of E.N.T at Nawabshah Medical Centre, Nawabshah over the period of two years [2004 to 2006]. One hundred patients of either sex and in the age group between 25-79 years with symptoms of chronic laryngopharyngeal disorders were selected for study. All patients had physical examination of upper aero digestive tract. Direct laryngoscopy was done to evaluate the status of larynx, however rigid esophagoscopy was done to evaluate the status of esophageal mucosa and biopsies from lower part of esophagus were taken in all patients. Eighty percent of patients with symptoms of chronic laryrigopharyngitis were also suffering from microscopic Oesophagitis. Among the 80% patients 87.5% were having non-erosive oesophagitis while 12.5% were having erosive oesophagitis. In significant number of patients with chronic upper respiratory symptoms resistant to the treatment, there was co existing gastroesophageal disease which could be the cause of the symptoms