Cannulated screw fixation of fracture neck of femur

To determine the outcome of cannulated screw fixation of intra capsular fracture neck of femur in terms of union rates and complications. Retrospective case series study. This study was carried out at the DHQ Teaching hospital Abbottabad and Gilani hospital Abbottabad from March 2008 to March 2011. Twenty four patients with intracapsular fractures neck of femur younger than 65 years of age including Garden I-1V, were fixed with cannulated screws, and included in this study. All cases were done by one surgeon and were followed for twenty four months. Union was recorded in twenty one patient's i.e. 87.5%. One patient from Garden III and two patients from Garden IV went in to non-union and were converted in tohemiarthoplasty. Combined Union rate of Garden III and IV was 78.57%. Cannulated Screw fixation of intracapsular fracture neck of femur is a safe and effective method

Comparison of cephalometric norms of pleasing faces reporting to OPD of orthodontic department L.U.M.H.S Jamshoro / Hyderabad

This study was aimed to analyze cephalometric norms in Pakistani population in comparison with the standards of European-American Adults. Cross sectional study. This study was carried out at Dental OPD Department of Orthodontic Dentistry Liaquat University Hospital Hyderabad/Jamshoro from August 2012 to December 2012. Cephalometric norms were analyzed on a sample of 60 patients, with full complement of permanent teeth and no previous orthodontic treatment. The consent was taken and the patients were informed for the amount of radiation exposure related to cephalometric radiography. Lateral cephalometric radiographs of the patients were exposed in centric occlusion. The cephalometric radiographs of patients were traced manually on acetate papers. Each radiograph of the patient was traced at the same sitting to minimize tracing errors. In this study nasolabial angles were measured for comparison with European-American Adults. The database of study sample measurements was developed in SPSS version 17. The arithmetic mean, range and standard deviation for all the concerned variables were determined using the above-mentioned software with the help of SPSS processor. P value < 0.05 was considered significant. The results suggest that the study sample comprised of [53.3%] males and 28 [46.7%] females. Nasolabial angle of the patients were statistically analyzed and the minimum angle noted was 90 degree, maximum was 150 degree, mean angle was 108.45 degree and standard deviation was 10.98 degrees [p < 0.001]. Females showed more sharp nasolabial angles [p < 0.01]. Comparisons revealed statistically significant differences in cephalometric norms between the study population in comparison to standers of European-American population

Benign lesions in abdominal hysterectomies in women presenting with menorrhagia

Menorrhagia is a common and debilitating problem. It is one of the major causes leading to hysterectomy in women all over the world. Menorrhagia is most commonly associated with benign pathologies like uterine fibroids, adenomyosis and pelvic infection. Rarely it is secondary to malignant pathology like endometrial carcinoma. Hysterectomy specimens form a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in total abdominal hysterectomy specimens in patients presenting with menorrhagia. A descriptive case series study of one hundred total abdominal hysterectomies of patients presenting with menorrhagia carried out. Patients' data and detailed gross examination of specimens were recorded on a proforma. Representative sections were taken for microscopic examination and findings were recorded. The ages of the patients ranged from 30- 59 years with maximum number [73%] of cases in 40 - 49 years age group. Macroscopically fibroids were seen in 69% cases in myometrium. Microscopic examination of cervix revealed features of chronic cystic cervicitis in 100% cases. Endometrial histology showed disordered proliferation [41%] followed by hyperplasia [25%] as the commonest finding. Myometrium revealed foci of adenomyosis in 49% cases. The commonest neoplastic lesion was leiomyoma [69%]. In patients with menorrhagia the commonest neoplastic lesion was leiomyoma [69%], and commonest histopathological cervical lesion as chronic cervicitis [100%]. Endometrial hyperplasia was the most common lesion [41%] on endometrial histology. Myometrium revealed foci of adenomyosis in 49% cases

Pattern of benign morphological myometrial lesions in total abdominal hysterectomy specimens

Hysterectomy is one of the most common major surgical procedure performed all over the world. Indications for total abdominal hysterectomy include dysfunctional uterine bleeding, leiomyoma, adenomyosis, chronic pelvic pain and pelvic inflammatory disease. Other causes include endometrial hyperplasia, cervical intraepithelial neoplasia. invasive cancer and endo-metrial malignancy. Hysterectomy specimens contribute a major component of histopathological work in Pathology laboratories. The present study was undertaken in Pathology department, Allama Iqbal Medical College, Lahore to find out the morphology and frequency of different benign histopathological lesions in myometrium of uterus in total abdominal hysterectomy specimens. A descriptive case series study of one hundred total abdominal hysterec-tomy specimens was carried out in Allama Iqbal Medical College, Lahore. One hundred total abdominal hysterectomy specimens were studied. The ages of the patients ranged from 30 - 69 years with maximum [73%] cases in 40 - 49 years age group. The commonest presenting complaint was menorrhagia [68%]. The two benign histopathological lesions in myometrium were leiomyoma and adenomyosis. Myometrium revealed leiomyoma in 6g% cases and foci of adenomyosis in 47% cases. The commonest benign histopathological lesion in myometrium was leiomyoma [69%] followed by adenomyosis [47%]

Indications and complications of intestinal stomas -a tertiary care hospital experience

An intestinal stoma is an opening of intestine on the anterior abdominal wall made surgically. The commonly performed procedures include colostomy and ileostomy. The purpose of the present study was to identify indications for commonly performed intestinal stomas and to study complications related to it. An observational study was carried out in Services Hospital Lahore, over a period of two years from Feb. 2007 - 09. A total of 85 patients needing intestinal stomas, ileostomy or colostomy, were included in the study. Patients under 12 years, with enterocutaneous fistula and urinary conduits were excluded from study. Indications, immediate and late complications of stomas were recorded. Reversal of stoma usually performed after 12 weeks and complications of reversal were also recorded. Majority [73%] of patients were males. There were 36 ileostomies and 49 cases of colostomy making a total of 85 patients. Main indications of Ileostomy were intestinal tuberculosis [58%], enteric perforation [31%] and penetrating injuries [5.5%]. Colostomy was mostly required in penetrating injuries [33%], blunt trauma [23%] and intestinal obstruction [28%]. In a total 0/35 stomas local complications appeared in 54 [41.77%]. General problems included anxiety, psychological and social isolation. Skin excoriation and ulceration were the most common [25%]; they were worse in ileostomy than colostomy. In laparotomy wound infection [9.4%], stoma diarrhea [7%], stoma retraction [6%] and prolapse [6%] were other notable comp-lications. A mortality rate of 1.6% was found in cases of ileostomy. Hospital admission ranged from 10 - 62 days. 62 stomas including 25 ileostomies and 37 colostomies were closed on an average of 3 months after primary operation. There were 9 cases of wound infection, three anastamotic leakages and a single mortality [1.6%] in the stoma reversal group. Common indications for intestinal stomas were abdominal trauma, intestinal tuberculosis and enteric perforation. Main complications included local skin problems, stoma diarhoea, prolapse and retraction. Early identification and treatment of tuberculosis and enteric fever can reduce stoma formation and its associated complications

Oesophageal atresia: role of gap length in determining the outcome

Twenty neonates born with oesophageal atresia and tracheoesophageal fistula over a period of two years were managed and the role of gap length between the two ends of oesophagus on the outcome was studied. Twelve [60%] were males and 8 [40%] were females. Body weight ranged from 2.2 kg to 3 kg. Only 2 [10%] were received within 24 hours of birth. Six [30%] were received within 48 hours of birth, 3 [15%] were 3 days old and 9 [45%] were 6 days old at the time of admission. Gap between the upper pouch and the lower fistulous end of oesophagus was 2cm in 4 [20%], >2cm but 3cm in 8 cases [40%] and >3 cm in 8 [40%] cases. Preoperatively chest infection was found in 16 [80%] cases. Associated congenital malformations were found in 7 [35%] cases. Primary anastomsis of Oesophagus was performed in all the cases. In order to relieve the tension on the anastomosis upper segment circular myotomy was performed in 8 [40%] cases. Post operative survival was 45%. Early postoperative complications among survivors included anastomotic leak in 3 [33%], pneumonia in 2 [22%] and wound infection in 2 [22%] cases. Late complications included gastroesophageal reflux in 7 [78%] and stricture formation in 6 [67%] cases. Major cause of death was sepsis secondary to chest infection. Authors conclude that prognosis of oesophageal atresia-tracheoesophageal fistula is excellent in children born with gap length 2cm. Morbidity and mortality increases proportionately as gap length increases beyond 2 cm

Incidence of respiratory distress syndrome

To determine the incidence of respiratory distress syndrome [RDS] in hospital born babies. Design: A prospective study. Place and Duration of Study: The study was conducted in the neonatal intensive care unit [NICU] at the Pediatric department, in collaboration with the Obstetrics and Gynecology Department, Military Hospital, Rawalpindi, over a period of one year from January to December 2000. Subjects and All live born infants delivered at the hospital and who fulfilled the diagnostic criteria of respiratory distress syndrome [RDS] were included in the study. Ninety-four neonates developed RDS. Out of these, 88 [93.61%] were preterm and 06 [6.38%] were term infants. There was a male preponderance [65.95%]. RDS was documented in 1.72% of total live births, 37.28% of preterm and 0.11% of term neonates born at the hospital. The incidence of RDS was 100% at 26 or less weeks of gestation, 57.14% at 32 weeks, and 3.70% at 36 weeks. The mortality with RDS was 41 [43.61%]. RDS is the commonest cause of respiratory distress in the newborn, particularly, in preterm infants. It carries a high mortality rate and the incidence is more than that documented in the Western world

Modified Duhamel procedure for Hirschsprung's disease: an analysis of 24 cases

A Prospective analytic study of 24 case of Hirschsprung's disease [H.D] was conduct over a period of two years first January 2000 to December 2001 in the Department of Paediatric Surgery, Mayo Hospital, Lahore, to evaluate the outcome of the patients after modified Duhamel pull through procedure. The results showed that Modified Duhamel procedure with the help of Mechanical stapling device had minimum complications with no mortality and were consistent with other studies showing that Modified Duhamel procedure is quite safe for Hirschsprung's Disease

Spontaneous rupture of an epithelial cyst of the spleen treated by partial splenectomy

Splenic cysts are rare. The authors describe a patient with an epithelial splenic cyst who presented with spontaneous rupture and was treated by splenic conservation. The types, presentations, diagnosis and treatment options of splenic cysts are discussed