Supraclavicular artery flap "its weightage in reconstructing burn neck contracture"

Flexion contractures of neck are a common sequel of deep burns. Severity varies from discrete linear bands to severe labiomentosternal contractures leading to functional and cosmetic impairment. Use of local flaps can produce best restoration of form and function. This study was meant to analyze clinical utility, advantages and any complications specific to islanded supraclavicular artery flap. This was a descriptive study carried out at department of plastic and reconstructive surgery Mayo hospital Lahore between January 2005 and November 2006. Ten patients presenting with neck contractures with out evidence of trauma in supraclavicular fossae, shoulder and deltoid region were included in the study. History and physical examination details including extent of contracture and cosmetic impairment were endorsed. Essential preoperative workup was done accordingly including assessment by anesthetist. Ten patients with varying severity of neck contractures were included in the study. Age range was 15-35 years. Average hospital stay was 10 days. Five patients had severe labiomentosternal contractures. Eight patients reported neck wound appearing excellent at 6 months postoperatively. In contrast donor area appearance was reported satisfactory by 7 and poor by 3 patients at 6 months. Functional consequences were most with 6 patients having full range of motion [ROM] and 4 patients having limited but satisfactory ROM. There is no reported recurrence so far. Supraclavicular artery based islanded fasciocutaneous flap is a reliable reconstructive tool ideally suited to cover defects in the region of neck to restore form and function

pattern of diseases in a surgical unit at a tertiary care public hospital of Karachi

Objective: To study the pattern of diseases in patients admitted in a surgical unit of tertiary care public hospital in Karachi

Design: Descriptive retrospective analysis of patients admitted from January 1, 2004 to June 30, 2004

Setting: Surgical Unit IV, Civil Hospital, Karachi

Results: A total of 501 patients, 284 [56.7%] males and 217 [43.3%] females were admitted during a six months period in Surgical Unit IV of Civil Hospital, Karachi. Out of these 296 [59.1%] patients were admitted through OPD, 190 [37.9%] came from emergency and 15 [3%] from other units. The majority of patients i.e. 114 [22.8%] had gastrointestinal related diseases followed by hernia 94 [18.8%], hepatobiliary diseases 69 [13.8%], ano-rectal diseases 37 [7.4%], abscesses 35 [7%], trauma 28 [5.6%], thyroid diseases 20 [4%], testicular and scrotal related problems 19 [3.7%], breast diseases 17 [3.4%] and tetanus patients 10 [2%]. Diabetes mellitus was the commonest associated disease seen in 60 [12%] patients. Four hundred forty-one [88%] patients were discharged after successful treatment while 10 [2.2%] expired during the study period

Conclusion: This study revealed that the commonest cause of admission was gastrointestinal related problems including acute abdomen, followed by hernias and hepato-biliary diseases, while diabetes mellitus was the most common associated disease

Health sector in Kuwait: analytical study

This paper presents an analytical study of the health sector in Kuwait. The structure and development of the health establishments and medical staff are discussed. The regression analysis tool is used. Major indexes are used to compare health service levels in Kuwait with other countries of the world. These indexes are population per physician and population per bed. It can be demonstrated that the service level in Kuwait compares favourably with most developed countries. A projection for the requirements of medical staff and beds in the year 2000 is given. Recommendations are given for a better balance between "supply" and "demand" of medical staff