To determine the frequency of acceptable postoperative astigmatism following phacoemulsification with unsutured 6mm limbal lncision

Objectives: To determine the frequency of acceptable postoperative astigmatism following phacoemulsification with unsutured 6mm limbal lncision

Methods: 65 cataractous eyes of patients attending the outpatient department and admitted in . . were studied from 7 January 2010 to 16 June 2010 at Department of Ophthalmology, Fatima Jinnah Medical College/ Sir Ganga Ram Hospital Lahore. it was a descriptive case study. All patients under went phacoemulsification with sutureless 6 mm limbal incision and rigid PMMA intra ocular lens implantation. Preoperative and postoperative keratometry reading were taken and difference was presented as acceptable astigmatism if less than +/- 1 D. Acceptable astigmatism [Yes, No] presented as percentages and frequencies

Results: The mean postoperative astigmatism was 0.31D with SD of +/- 0.58 D. it was found to be acceptable astigmatism' In 57 patients [87. 7%] while 8 of patients [12.3%] were out of the range of acceptable astigmatism

Conclusion. Postoperative astigmatism after phacoemulsification with 6 mm sutureless limbal incision is within acceptable range and eliminates significant postoperative refractive error

Child birth; comparison of complications between lithotomy position and squatting position during

The purpose of the study was to compare the complications of delivery in squatting and lithotomy position of mother. Randomized controlled trial. Gynecology/Obstetrics Unit-II, Sandeman Provincial Teaching Hospital, Quetta. 6 months [05 Oct, 2011 to 05 April, 2012]. Hundred and fifty one patients with lithotomy position in delivery were compared with hundred and fifty one patients with squatting position in delivery regarding risks of perineal tears, periurethral tear, extended episiotomy, instrumental delivery, caesarean section and primary postpartum hemorrhage. Data was recorded on a specially designed Performa and was analyzed by using SPSS.V. 10. Results were compared using Chi-square test by keeping the p-value of < 0.05 as significant. 151 patients in lithotomy position and 151 patients in squatting position were compared and studied for complications during delivery. Extension of the episiotomy was observed in [7%] of non-squatting groups. There were no extensions of episiotomy in squatting group. There were no second degree, or third degree perineal tears in squatting group which were encountered in [9%] patients in the lithotomy position group [P<0.05]. Forceps application was also less in squatting position group 11% patients, whereas 24% patients were delivered by forceps in lithotomy group, [P<0.05]. One patient in the lithotomy position had to have a caesarean section due to persistent occipito-posterior position. There was no case of retained placenta or postpartum hemorrhage in squatting group whereas there were 4% cases of retained placenta and 1 case of postpartum hemorrhage due to atony of the uterus in lithotomy position group. It appears that the routine use of lithotomy position may have some disadvantages in terms of more instrumental deliveries and episiotomies. Moreover women experience significant pain in this position. It is suggested that more trials should be conducted and the position at the moment of birth should be registered to measure its influence on birth outcome

Tubo-omental ectopic pregnancy

Tubo-omental pregnancy is a very rare form of ectopic pregnancy. Here we present a case of tubo-omental pregnancy diagnosed at surgical exploration. A 26-year-old woman presented with abdominal discomfort, nausea and vomiting. There was ectopic pregnancy with viable foetus in the right adnexa and haemoperitonium. Laparotomy was performed and on exploration tubo-omental pregnancy was found attached to fimbria at one side and omentum at the other. Fimriaectomy and partial omentectomy was performed. The patient had a successful post-operative recovery

Vesico-vaginal fistulae; review of the causes, diagnosis and treatment

To review the causes, diagnosis and treatment of vesico-vaginal fistulae in the department of Gynaecology and Obstetrics, and Urology Department Civil Hospital Quetta. Vesico-vaginal fistula is not life threatening medical disease, but the woman face problems like demoralization, isolation, social boycott and even divorce. The etiology of the condition has been changed over the years and in developed countries obstetrical fistula are rare and they are usually result of gynecological surgeries or radiotherapy. In countries like Pakistan the situation is different, here literacy rate is low, parity rate is high and medical facilities are deficient. People manage delivery at home and usually multi parity. Urogenital fistula surgery doesn't require special or advance technology but needs experienced urogynecologist with trained team and post operative care which can restore health, hope and sense of dignity to women. A retrospective study of 60 patients with different types of vesico-vaginal fistula werereviewed between January 2005 to December 2008. Patients were analyzed with regard to age, parity, cause, diagnosis, mode of treatment and outcome. Patients were also evaluated initially according to prognosis. During the study of four year period 60 patients of vesico-vaginal fistulae were reviewed. Majority of the patients were belonging to middle age group. In 48 patients repair was done through transvaginal route and 12 were operated through transabdominal route. One Ca patient expired and in 4 patients recurrence occurred. Iatrogenic vesico-vaginal fistulae are more common. Difficult and complicated fistulae need experienced surgeon. Establishment of separate fistula surgery unit is suggested to get desired results

Associated injuries with facial trauma - a study

Objectives: the objectives of the study were to determine the incidence of associated injuries with maxillofacial fractures and to enlist the age and gender distribution of maxillofacial trauma and also to find out cause, bone most frequently affected with it

Material and methods: history was taken from patients affected with facial trauma along with 2 diagnostic radiographs. Age, gender, cause, type of injury and fractures elsewhere in the body were recorded. Study was carried out at Emergency Department of Liquate University Hospital Hyderabad in a period of 1 year i.e. from 1[st] January 2011 to 30 December 2011

Results: total of 680 patients was included in this study. Out of these males were predominantly affected [72%], mean age was found to be 36.4 years. Road traffic accident [RTA] was the most common cause of injury [51%] and mandible was the most common bone involved [51%]. Out of associated injuries tibia [12.35%] and ulna [11.23%] were most common injuries

Conclusion: our study showed a high frequency of trauma in males in 3[rd] decade of life. Road traffic accident [RTA] was the most common cause and mandible the most common bone affected. Tibia and ulna were common associated injuries with facial trauma

Preliminary observations of digit retention in Pakistani population

Test of digit retention was carried out to investigate if the usually accepted norm of 7 forward digit retention holds true in our population. The highest mean score of 8.85 was obtained by executives. Professionals scored a mean of 8.08 followed by students [7.81]. Housewives, skilled workers and unskilled workers scored less than the accepted norm of 7 digit forward retention. A strong influence of vocational and socio-cultural background in ability to score in this test is shown in this study and it must be considered when passing judgement on the patient's mental abilities in clinical assessment