Pravastatin induced myopathy

Lipid-lowering agents such as HMG-CoA reductase inhibitors [also known as statin drugs] are generally well tolerated. But a recognized side effect still can happen, We report a case of 47-year-old Iraqi male patient previously known hypothyroid, was not on replacement therapy, as he did not appear after his thyroid functions was checked came in with severe body pain for 10 months got worse in the last three months, started on lipostat [ten months ago] found to have myopathy as evident by high CPK which improved gradually clinically and biochemical after stopping lipostat

Arthritis in inflamatory bowel disease

Inflammatory bowel disease is a systemic disorder with intestinal and extra-intestinal features. Arthritis is a well recognized extra intestinal manifestation. Spondylitis, sacroiliiatis are the common involvement with IBD. NSAIDs are generally recommended in the treatment with caution due to its potential of flaring up the gastrointestinal symptoms. Sulphasalazine, methotraxate, aziothioprine and anti TNF alpha agents are licensed for treatment of arthritis in IBD

Renal transplant complications, role of resistive index on colour doppler ultrasound

We evaluated 50 patients who had renal transplants and were sent for Doppler Ultrasound for complications, after the transplant procedure. Ages of the patients ranged from 20 to 65 years, 39 were male and 11 were female. In inclusions only first month post op patients were included and only those patients were considered who had some sort of complications on ultrasound at some stage of the follow up.Following complications were noticed: Diminished corticomedullary demarcations, increased echogenicity with raised R I [20 pt]. Perinephric collections other than haematoma [13 pt]. Perinephric haematoma [06 pt]. Obstructed transplanted kidney [05 pt]. Diminished arterial vascularity of the kidney [04 pt] Renal vein thrombosis [02 pt]. RI was found to be raised in increased echogenicity, obstructed hydronephrotic kidney, diminished arterial supply and was disturbed in RVT

Doppler evaluation of breast solid masses differentiation of benign and malignant masses role of resistive index

To know the usefulness of color and spectral doppler in evaluation of solid breast masses using vascularity and resistive index. We performed duplex doppler sonography on 100 patients presenting with breast mass. Resistive index and vascularity of the vessels were detected and analyzed and correlated with histopathological results. 70% of the benign lesions were found having ri below 0.8 and 45 out of 50 patients had low vascularity.43 malignant lesions had high vascularity and 80% had ri above 0.8. High flow visualization on power doppler and indicates a higher possibility of malignancy lesions with ri greater than 0.8 gives high probability of malignancy

Induction of labour single vaginal PGE 2 Vs early amniotomy and I/V oxytocin

To compare two methods of induction of labour. Amniotomy with intravenous oxytocin infusion versus single use of prostaglandin E2 vaginal tablet. Design Perspective randomized clinical trial. The department of Gynae and Obs Nishtar Hospital Multan and Ganga Ram hospital lahore 100 patients were recruited .50 were randomized for amniotomy followed by oxytocin infusion. Second group underwent labour induction with PGE2 which was repeated after 6 hours, if n o change in bishop score is observed. 17 .2 .2004 to 17 .2.2005 In the study the results regarding mean Bishop score change, duration of labour and apgar score at 5 minutes were comparable in both groups. In the group 2 mean induction to delivery time was 9 hours.[6-12 hrs].The mean cervical change score was 8.5 Duration of labour in group 2 was in the mean of 7hrs. In group 1 mean cervical change was 7.5 [range5-7], induction to delivery time was 10.5 hrs. The duration of labour was 7.5 hrs. Analgesic requirements varied in both groups. No patient with PGE2 required pain relief before membrane rupture. In the oxytocin group narcotic analgesia was given from the start of uterine contractions. PGE2 vaginal tablet for induction of labour in case of unfavourable cervix is superior to use of amniotomy and oxytocin. It was found to be safe and effective with minimum of patient interference

CT scan in evaluation of cardiac masses

To evaluate the usefulness of CT scan in Cardiac tumor A descriptive study with convenient sampling. We studied seven cases referred to us for work up of cardiac masses, the contrast enhanced CT scan was able to identify and give the extent in five of these patients. Two patients were negative on CT scan but were confirmed to have a mass in the cardiac chamber by echocardiography. While CT was able to identify the thrombotic mass extending into the heart in two of the patients which remained inconclusive on echocardiography. CT is better modality for the extent of the lesion and echocardiography is better as an initial modality to screen the cardiac chambers

it aleays DVT? evaluation of leg swelling with color doppler sonography

The aim of this study was to assess the value of duplex ultrasound examination in establishing diagnosis in swollen lower limbs. This study was conducted at the Department of Diagnostic radiology Mayo hospital Lahore. 50 consecutive patients presenting with leg swelling, submitted for colour Doppler sonography of the lower extremities were examined for deep vein thrombosis [DVT]. 46% of the patients were detected as having DVT, when examined through Doppler Ultrasonography. While 28% of the patients were not having any pathology in the limb.26% of the patients were having pathology other than DVT. The veins of the calf muscles are a common site of acute DVT and a source of pulmonary embolism. They should always be investigated in patients with leg swelling. Complete venous evaluation with duplex imaging can be very helpful in determination of underlying cause of the swelling

External genitalia injuries, a study of aetiological factors and management options

This study includes 35 patients, more than 12 years of age, with external genitalia injuries. They presented in the emergency Department of the Sir Ganga Ram Hospital, Lahore, during last 4 years [2000-2004]. Our main aim was to highlight the fact that most of these injuries are caused by rotating belt or wheel of a machine and are potentially preventable if proper precautionary measures are taken. Another aim was to discuss different management options. It has been concluded that rotating belt or wheel of a machine is the most common cause of these injuries, especially if someone is wearing loose traditional clothes

Incidence of negative appendice, our experience of 100 patients at Sir Ganga Ram Hospital, Lahore

Despite recent advances in diagnostic medicine, the diagnosis of Acute Appendicitis is still doubtful in a number of cases. Majority of the Clinicians rely on their clinical examination, strengthened by the laboratory tests. This study was done to see the incidence of negative appendicectomy in Patients, who presented in surgical emergency with pain in Rt. Iliac fossa. These patients were assessed and evaluated by clinical examination as well as with the help of Modified Alvarado Scoring system and surgery was decided accordingly. To see the incidence of Negative appendicectomies at Sir Ganga Ram Hospital, Lahore and comparing the rate with the rate of other international Studies. It was a prospective clinical and Pathological study, consisting of 100 patients, presenting in the Sir Ganga Ram Hospital Lahore, with history of right iliac fossa pain. One hundred patients were included in the study, and diagnosis of acute appendicitis was bas ed on Clinical Examination and Modified Alvarado Score. The patients selected for this study were of all age groups and both sexes. Out of hundred, 56 patients were operated after being assessed by clinical Examination and Modified Alvarado Scoring System. The incidence of negative appendicitis was about 7% in male, 20% in female and about-10% in children. Over all the rate of negative appendicectomies was 15%, which is with in lower limit of the other international studies

Disease pattern of breast masses in men with advancing age

Breast enlargement is not unique among men but the benign breast diseases must be differentiated from the malignant lesions. Infiltrating ductal carcinoma is the most common histopathological presentation whereas gynecomastia is the commonest benign lesion. The age of the patient, presenting complaint, and history of various predisposing factors provide a clue to the diagnosis. This article illustrates the history, clinical presentation and histopathological records of 20 patients, above 35 years of age, who presented in a 2-year period in the Services hospital Lahore

Laparoscopic findings in infertility

A study was carried out over a period of 12 months from 1.1.95 to 31.11.95, in which 200 [female] patients were subjected to laparoscopy to evaluate various factors regarding infertility. The study highlighted various symptoms of infertile patients [female] and obvious pathologies seen with the laparoscope such as tubal adhesions, uterine diseases, status of ovaries or any associated condition like endometriosis or pelvic inflammatory disease. The study also illustrates the complications occurring during the laparoscopic procedures

Nasal drops and mixture of liver protecting herbs relating to hepatitis C-virus treatment

Cell-sap of two wild plants, after separation of toxic agents were used as antiviral in the form of nasal drops. The extract is tested as antiviral of different strains. The result provides considerable encouragement for the eventual control of hepatitis virus infection. These drops are of great values if it administrated in combine with oral herbs protecting liver