unusual cause of hydronephroureter

Intrauterine contraceptive device [IUCD] is a common method of contraception among women because of its low cost and high efficacy. Perforations are possible resulting in multiple complications including urinary complications. Obstructive hydronephrosis and hydroureter is one of the main clinical concerns in genitourinary practice leading to radiological investigations for determination of the cause. Determination of the cause leads to early treatment, hence saving the renal function. In this case report, we describe hydronephrosis and hydroureter secondary to a migrated/displaced IUCD

Incidence of homicide by sharp edged weapon at Lahore

To find out the most frequently targeted site of the body in sharp force homicidal injuries, defence wounds, age, associated weapon use, gender incidence and cause of death. Department of Forensic Medicine and Toxicology, King Edward Medical University, Lahore. 2002, 2003 and 2004. Proforma was designed for retrospective study, relevant information was gleaned from the available record .A three year period was selected, spreading over 2002, 2003 and 2004, was scrutinised for 232 cases autopsied at this facility. Male to female ratio was 2.26: 1. Maximum number of victims belonged to the 20-29 years age group. Single injuries were present in 18.54% of the cases and multiple were present in 81.46% cases. The commonest associated weapon used was blunt. Death was caused by haemorrhage in 46.5% cases and damage to vital organs proved to be the cause of death in 53.5% cases. Defence injuries were seen in 26.7% cases. The commonest infliction site was the neck in females while the area most targeted in male victims was the chest. The most targeted site is neck. Approximately one in four victims had defence injuries. Most injuries are on trunk [chest and abdomen]. Commonest regions for males was chest and in females. Damage to vital organs was the major cause of death. Amongst females teenager are more vulnerable, as this group had the maximum number of victims

Ultrasonograpny; diagnostic role of in acute abdomen [nongynaecological causes]

[1] To determine the role of ultrasonography as the primary imaging modality in patients of acute abdomen. [2] To evaluate the sensitivity, specificity, positive and negative predictive value of ultrasonography in acute abdomen. A hospital based descriptive study. In Combined Military Hospital Lahore which is a tertiary care hospital. From 1[st] Jan 2003 to 30 Dec 2003. A total of 100 consecutive patients of acute abdomen were selected for the study. There were 61 male patients and 39 female patients. The patients' age ranged from 02 years to 70 years. Ultrasonography was done using ALOKA SSD-5500 machine with high resolution probes. During my study of patients of acute abdomen most common conditions encountered were renal colic due to renal and ureteric stones followed by gut perforation, cholecystitis, appendicitis and cholelithiasis. My study revealed a sensitivity of 79.7% and specificity of 88.4% of ultrasonography in patients with acute abdomen. The positive predictive value was 95.1% and a negative predictive value was 60.5%. Ultrasonography helped in prompt decision making in most of the cases of acute abdomen with a high sensitivity and specificity in skilled and experienced hands, as well as high positive predictive value. Hence, in our setup it can be used as a primary imaging modality for patients presenting with acute abdomen in any age group, as it is readily available, cost effective and free of any radiation hazards. Ultrasonography not only helps in diagnosing the cause of pain but also ruling out other possibilities

Role of thyroid peroxidase antibodies in the outcome of pregnancy

To assess the prevalence of Thyroid peroxidase [TPO] auto antibodies among pregnant women and its relation with their pregnancy outcome. Cross-sectional analytical study. The study was carried out at Zayed Medical Complex, Lahore, in the department of Obs/Gynae and NHRC from July 2000 to July 2002. The study included 1500 Euthyroid pregnant women, ages 18 - 40, registered for antenatal care at Obs/Gynae department. Previous fertility history was recorded and thyroid peroxidase antibody level was assessed by ELISA method. A cut off value of TPO antibody of upto 100U/ml was considered negative and more than 100 U/ml was considered positive.The cases were followed for the outcome of their pregnancy and compared with TPO antibody levels. A comprehensive proforma was used to collect the data. The prevalence of positive TPO autoantibodies was found to be 11.2%. The raised TPO autoantibodies were found to have higher risk of abortion [O.R 49.2] and prematurity [O.R.8.1]. The complications were found to be significantly raised among positive TPO autoantibodies cases, when analysed by parity and age of mother at time of registration. Thyroid autoimmune diseases among euthyroid pregnant women may contribute to low-birth-weight of neonates and high abortion rate in all pregnancies. Raised levels of TPO autoantibody is a good marker to assess early hypothyroidism state and should form a screening modality in Pakistan

Microalbuminuria as an indicator of kidney function among diabetics

To find out the role of microalbuminuria as an indicator of kidney function among diabetics. Comparative study. Diabetes control clinic of Shaikh Zayed Hospital, Lahore, a tertiary care hospital, was the venue. The study was conducted during March 2002 to August 2003. Timed overnight urine samples were collected from all subjects and albumin was estimated using Radioimmunoassay [RIA] method. Albumin excretion rate [AER] was assessed in three groups including normals, Type 1 and Type 2 diabetics. AER over 30 mg/min was considered as significant. A significantly higher proportion of AER was observed in both types of diabetes. A higher proportion of increased AER was observed in females of Type 2 diabetics. The study has indicated that irrespective of the duration and type of diabetes the damage to the kidney can be avoided if good glycemic control is achieved

prospective analysis of thyroid profile with the emphasis on Grave's disease

This study suggests that there is no relationship between the clinical assessment of disease severity and serum levels of thyroid hormone in untreated Grave's disease. Potential variables such as cellular responsiveness to thyroid hormone and/or catecholamines and their resultant effect to produce hyperthyroid symptoms could contribute to the lack of a linear relationship between serum thyroid hormone levels and severity of thyrotoxic symptoms