Pattern of change in the frequency of Helicobacter pylori with perforated duodenal ulcer

Peptic ulcers were believed to be caused by stress, dietary factors, and gastric acid, but the link between H. pylori and peptic ulcers was identified in 1983. To see the frequency of Helicobacter pylori infection in patients with perforated duodenal ulcer and advise eradication therapy in these patients. This cross sectional study was conducted in Surgical Unit Hayatabad Medical Complex, Peshawar, during January 2007-June 2008. A total of 50 cases were included in the study. All cases presenting to our unit with acute perforated duodenal ulcer were recruited. After resuscitation and baseline investigations, all underwent emergency laparotomy via upper midline incision, after thorough peritoneal lavage, the perforation margins were freshened and closed over an omental patch. Serum from every patient was tested for H. pylori and accordingly managed. Out of the 50 cases, 45 were males, and 5 were females. Age ranged from 20- 80 years old. All patients underwent emergency laparotomy. Postoperatively, all were started on PPI treatment and serum testing for H. pylori was done. Thirty-four [68%] turned out positive and 16 [32%] were found to be negative for H. pylori. There is still a high frequency of H. pylori infection in patients with perforated duodenal ulcer. But comparing these results with the various data available, there is a significant decline in H pylori positive perforated duodenal ulcer patients

Penile fracture: experience at Ayub teaching hospital

Penile fracture is a relatively rare traumatic rupture of the tunica albuginea of one or both corpora cavernosa of an erect penis. It is a real urological emergency which needs early assessment and surgical management. Twelve [12] cases of penile fracture were reviewed from July, 1997 to July, 2007 in the Department of Urology, Ayub Teaching Hospital Abbottabad. All cases presented with classical history of penile fracture and the diagnosis was made on the basis of history and clinical examination only. All the patients underwent immediate surgical repair with well preserved potency and excellent overall results. Penile fracture has typical signs. Standard treatment consists of immediate surgical repair of penile fracture with a low incidence of late complications. Post op complications including urethral strictures and erectile dysfunction should be ruled out by regular follow-up

Type 2 diabetes mellitus: how well controlled in our patients?

Type 2 Diabetes mellitus has reached epidemic proportions worldwide and Pakistan is no exception. This study was done to see the glycaemic control of our diabetic patients by estimating Glycosylated haemoglobin and Fasting blood glucose as poor control leads to significant complications causing enormous human suffering and socioeconomic burden. This Cross-sectional study was conducted on Type 2 diabetic patients coming to medical OPD and medical B ward of Ayub Teaching Hospital between March-September 2007 fulfilling the inclusion criteria. Among 100 patients with type 2 diabetes forty two had HbA[1]c more than 7.5%, while seventy had fasting blood glucose more than 120 mg/dl. All patients with HbA[1]c more than 7.5% had increased fasting blood glucose. While thirty out of seventy patients with fasting blood glucose more than 120 mg/dl had HbA[1]c less than 7.5%. None of the patients with fasting blood glucose less than 120 mg/dl had HbA[1]c more than 7.5%. Significant number of patients [42%] had poor control of diabetes as revealed by HbA[1]c, with FBG showing poor control in even more patients, i.e., 70%. However their blood glucose estimation was not frequent enough as required. Blood glucose results can be spuriously high and may lead to frequent change/ increase in the dose of hypoglycaemic medications. This can lead to poor compliance as well as psychological trauma to patients. HbA[1]c on the other hand is easy to interpret, reflects long term glycaemic control and cost effective. We recommend its more frequent use along with blood glucose for better glycaemic control and decreased chances of complications