Laparoscopic surgery in urology: an experience from a tertiary care center

Objective: To describe the results of laparoscopic procedures performed in a Urology unit of a tertiary care hospital

Study design: Case series

Place and Duration of study: Department of Urology Jinnah postgraduate Medical Centre Karachi, from March 2011 to February 2016

Methodology: Data of all planned laparoscopic surgeries were collected and analyzed for demographic information, laboratory reports, procedure details, operative time, duration of hospital stay, complications and follow up details. BAUS guidelines were used to learn laparoscopic skills. Data was analyzed using Statistical package for the social Sciences [SPSS, Version 20.0]

Results: There were total of 57 patients who underwent laparoscopic surgery. This included 48 males [84.21%], and 9 [15.7%] females. Mean age of patient was 30.37 +/- 12.01 year [Range 12-73 year]. The procedures performed included simple nephrectomy [n=13], ureterolithotomy [n=14], varicocelectomy [n=13], orchidopaxy [n=2]. There were 12 diagnostic procedures for non-palpable testes, one adrenalectomy, one radical cystectomy, and one vesico-vaginal fistula repair. Fifteen patients needed conversion to open surgery due to various reasons. Out of 42 successfully performed laparoscopic procedures 10 different complications were noted majority being Clavien Grade II, including blood transfusion in one patient

Conclusion: Laparoscopic surgery has a prolonged learning curve. The conversion rate in this study was 26.3%

Rare case of Spigelian Hernia, diagnosis and treatment

As it stands, Spigelian hernias are rare and generally overlooked or misdiagnosed. We report a case in which a Spigelian hernia presented to us as a painless abdominal swelling in a 39 year old obese female with no known co-morbids The hernia appeared as swelling in the right lower quadrant, which was non tender at the time of admission and showed no signs of strangulation. Diagnosis of the hernia was made on CT-scan and an open technique was adapted to repair it. The post op period was insignificant in the patient

new natural gel of Fagonia indica Burm f. extract for the treatment of burn on rats

Fagonia indica Burm f. [Mushikka or white spine] is a plant distributed in the deserts of Asia and Africa and reported to be medicinal in the scientific literature as well as in the folk medicine. Earlier investigations, the authors isolated a number of bioactive constituents from the plant including flavonoids, sterols and tritepenoids; In addition its flavonoidal content was found remarkably high reaching 3% [calculated as flavonol on dry weight]. The present study is an attempt to formulate, characterize and evaluate a natural wound-healing gel preparation containing the crude plant extract. Three formulae [F1-F3] were prepared. The gel properties such as viscosity, swelling ratio, bio-adhesion, in vitro release, stability, microbiological studies, in vivo burn healing test on rats and histopathological features were assessed. The results of the in vitro evaluation and stability studies showed that F3 [0.5% [w/w] of plant extract in 4% [w/w] chitosan] was significantly [p<0.05] the superior compared to other formulations. Besides, from the in vivo burn healing and histological results, F3 enhanced the skin wound re-epithelialization and speed up the healing process compared to the conventional commercial product. Thus, the Fagonia extract loaded chitosan topical gel would be used successfully in burn wound care.

Anti-inflammatory and gastroprotective activities of the aqueous extract of micromeria fruticosa [L.] druce ssp serpyllifolia in mice

Micromeria fruticosa is used widely in many Mediterranean regions for various inflammatory conditions. The aim of this work was to assess the anti-inflammatory and gastroprotective activities of the aqueous extract of Micromeria fruticosa. The aqueous extract of Micromeria fruticosa was tested orally in mice at doses of 50, 100 and 200 mg/kg in carrageenan-induced paw edema, vascular permeability, myeloperoxidase activity [MPO] and indomethacin-induced gastric ulceration. In the paw edema model, the extract at dose of 200 mg/ kg, exhibited a significant anti-inflammatory effect, while the extract at 100 and 200 mg/kg reduced significantly the vascular permeability and MPO activity in a dose dependant manner. Oral pretreatment of the aqueous extract reduced significantly the development of gastric lesions induced by indomethacin at dose of 200 mg/kg only. Results suggest that the aqueous extract of Micromeria fruticosa has both anti-inflammatory as well as, gastroprotective activities. Thus it could be used as an alternative or supplementary herbal remedy for the treatment of inflammatory diseases especially when combined with strong anti-inflammatory medications that have ulcerogenic side effects such as NSAIDs