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1.
PAFMJ-Pakistan Armed Forces Medical Journal. 2018; 68 (5): 1101-1105
in English | IMEMR | ID: emr-206427

ABSTRACT

Objective: To determine the accuracy of intraoperative radionuclide scintigraphy for detection of sentinel lymph node [SLN], using 99mTc-Nanocolloids, in patients with early breast carcinoma


Study Design: Cross sectional analytical study


Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi and department of Surgery, Pak Emirates Military Hospital, Rawalpindi, from Jul 2012 to Jun 2013


Patients and Methods: After fulfilling the inclusion and exclusion criteria and taking written informed consent, 67 patients of carcinoma breast were enrolled in the study. Each patient was injected with 37 MBq of 99mTc- Nanocolloids, via sub areolar, peri-tumoural route, pre-operatively. SLNs were identified using handheld gamma probe followed by excision biopsy. Patients, then, underwent modified radical mastectomy with dissection of axillary lymph nodes [ALN] and the samples were sent for histopathology


Results: Out of 67 patients, 28 to 77 years of age [mean +/- SD of 49.61 +/- 11.572 years], 17.9 percent [12] patients had T1tumour while 82.1 percent [55] had T2 tumour [mean +/- SD of 3.48 cm +/- 1.050 cm]. Histopathology revealed no metastasis in SLNs as well as ALN of 55.2 percent [37] patients while 40.3 percent [27] patients were positive for both. However, in 4.5 percent [3] patients SLNs were negative for metastasis with positive ALN. Diagnostic accuracy was calculated to be 95.5 percent, sensitivity 90 percent, false negative rate 4.5 percent and negative predictive value 92.5 percent


Conclusion: Intraoperative radionuclide scintigraphy, using 99mTc-Nanocolloids and handheld gamma probe is a reasonably accurate technique for localization of SLNs in early breast carcinoma

2.
PAFMJ-Pakistan Armed Forces Medical Journal. 2017; 67 (3): 467-471
in English | IMEMR | ID: emr-188580

ABSTRACT

Objective: To provide a comparative analysis of mean post-operative pain score after preservation and elective excision of ilioinguinal nerve [UN] using standard Lichtenstein hernia repair [LHR] technique


Study Design: Randomized controlled trial


Place and Duration of Study: Department of Surgery Combined Military Hospital [CMH] Rawalpindi/ Peshawar, from 15 May 2013 to 15 May 2014


Materials and Methods: One hundred and fifty patients with diagnosis of inguinal hernia satisfying inclusion/exclusion criteria were included. Patients were divided into two groups randomly. In group A, UN was carefully protected while excision were done in group B. Demographic as well as data concerning groin pain at 03 months post operatively were collected and analyzed using SPSS


Results: A total of 150 patients were included. Mean age in group A was 37.32 +/- 10.45 years while in group B was 36.56 +/- 10.26 years [p=0.653]. Majority of the patients in both groups were male [group A 89.33% [67], 92% [69] in group-B], while female constituted only minority [8 [10.67%] in group A and 6 [8%] group-B], the difference being statistically insignificant [p=0.571]. Majority of the patients had indirect hernia and mean operation time was similar in both groups. Mean postoperative pain score was 3.76 +/- 1.11 and 2.82 +/- 0.677 in group A and B respectively, the difference being statistically significant [p<0.001]


Conclusion: Mean post-operative pain score is higher in preservation techniques compared to elective excision of UN for the treatment of inguinal hernia


Subject(s)
Humans , Female , Male , Adult , Middle Aged , Herniorrhaphy/adverse effects , Neuralgia , Hernia, Inguinal/surgery , Case-Control Studies , Randomized Controlled Trials as Topic
3.
PAFMJ-Pakistan Armed Forces Medical Journal. 2016; 66 (4): 502-505
in English | IMEMR | ID: emr-182549

ABSTRACT

Objective: To compare the efficacy of vacuum assisted closure [VAC] therapy against regular moist wound dressings in reducing the surface area of open chronic wounds by at least 5 mm2 in terms of early closure of wound


Study Design: Randomized controlled trail


Place and Duration of Study: This study was conducted at general surgery department CMH/MH Rawalpindi from Jun 2011 to Dec 2011 over a period of 06 months


Material and Methods: A total of 278 patients [139 in each group] were included in this study. Group A received VAC therapy while moist wound dressings applied in group B


Results: Mean age was 54.9 +/- 7.2 and 53.4 +/- 8.9 years in group A and B, respectively [statistically insignificant [p=0.12]. In group A, 96 patients [69.0%] and in group B 92 patients [66.2%] were male while 43 patients [31.0%] in group A and 47 patients [33.8%] in group B were female the difference being statistically insignificant [p=0.608]. In group A, 63 [45.3%] patients showed significant reduction in the size of the wound while only 41 [29.5%] patients in group B had adequate wound healing at the end of 04 weeks, the difference being statistically significant [p=0.0064]


Conclusion: VAC therapy decreases wound size more effectively than moist wound dressing technique. It definitely reduces hospital stay and ensures early return to work

4.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2015; 25 (11): 789-793
in English | IMEMR | ID: emr-173283

ABSTRACT

Objective: To evaluate the clinical efficacy of Negative Pressure Wound Therapy [NPWT] using Vacuum Assisted Closure [VAC] compared with Advanced Moist Wound Therapy [AMWT] to treat Diabetic Foot Ulcer [DFU]


Study Design: Randomized control trial


Place and Duration of Study: Surgical Department, Combined Military Hospital [CMH] / Military Hospital [MH], Rawalpindi, from November 2010 to June 2012


Methodology: The study consisted of 278 patients, with 139 patients each in Group 'A' and 'B', who were subjected to AMWT and NPWT, respectively. Wound was assessed digitally every week for 2 weeks. Wound dimension and surface area were determined using University of Texas Health Centre at San Antonio [UTHCSA] image tool version 3.0. Efficacies of AMWT and NPWT were compared in terms of reduction in wound area over 2 weeks


Results: Mean age of presentation in group A was 55.88 +/- 10.97 years while in group B, it was 56.83 +/- 11.3 [p=0.48]. Mean duration of diabetes at presentation was 15.65 +/- 4.86 and 15.96 +/- 5.79 years in group A and B, respectively [p=0.74]. Majority of patients had Wagner's grade 2 ulcer [82% in group A and 87.8% in group B, p= 0.18]. Initial wound size in group A was 15.07 +/- 2.92 cm[2] and in group B 15.09 +/- 2.81 cm[2] [p = 0.95]. Wound size measured after 2 weeks, treatment was in group A 13.70 +/- 2.92 cm[2] and in group B 11.53 +/- 2.78 cm[2] [p < 0.001]. Wound area reduction in both groups revealed statistically significant faster healing in group B as compared to group A [p < 0.001]


Conclusion: NPWT using VAC was more efficacious than AMWT in the management of diabetic foot ulcers

5.
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2009; 19 (4): 254-256
in English | IMEMR | ID: emr-91650

ABSTRACT

A 25-year-old female having asymptomatic edema of unilateral leg was provisionally diagnosed as a case of psoas abscess. Later, she turned out to be a case of non-Hodgkin's lymphoma. This presentation is contrary to usual age and mode of presentation of non-Hodgkin's lymphoma


Subject(s)
Humans , Female , Lymphoma, Non-Hodgkin/epidemiology , Lymphoma, Non-Hodgkin/therapy , Psoas Abscess , Lymphatic Diseases , Lower Extremity , Ultrasonography , Tomography, X-Ray Computed , Antineoplastic Combined Chemotherapy Protocols , Leg , Edema
6.
PAFMJ-Pakistan Armed Forces Medical Journal. 2004; 54 (2): 259-264
in English | IMEMR | ID: emr-204742
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