Renal colic patient; comparison of un-enhanced helical computed tomography, intravenous urography and ultrasound + Plain X-Ray"

To compare Un-enhanced Helical Computed Tomography [UHCT], Ultrasonography [US] + Plain X-Ray and Intravenous Urography [IVU] in the evaluation of patients with suspected renal colic. In 70 patients with renal colic US, plain X-ray, IVU and UHCT were performed to demonstrate urinary stones and other relevant pathologies. Patients were then followed-up to stone passage or removal, and the course of clinical symptoms were noted. 57 patients had ureteral stones based on stone passage or removal. 13 patients did not have ureteral stones based on failure to recover a stone, disappearance of symptoms, and diagnosis unrelated to stone disease. Un-enhanced helical computed tomography was found to be the most useful method in the demonstration of ureteral stones with a sensitivity of 97%. Reformatted images clearly depicted the intraureteral location of stones in most cases. Spiral UHCT showed renal calculi in 15 patients, USG + KUB in 12 and IVU in 9 patients. Non-contrast axial and reformatted spiral CT [UHCT] images were found superior to USG + KUB and IVU in the depiction of ureteral and renal calculi. Reformatted images offer a good alternative to IVU in problematic cases

Ileo-colic intussusception; is hydrostatic reduction worth considering till late?

To evaluate the success rate of hydrostatic reduction of intussusception and incidence of complications in late presenting cases. Prospective study. Study was carried out in Armed Forces Institute of Radiology and Imaging Rawalpindi and different Combine Military Hospitals during last 5 years. All the children up to 2 years age with diagnosis of ileo-colic intussusception and 3 days or less history of onset of symptoms were included in the study. Patients with signs of perforation, suspicion of lead point or long intussusceptum protruding through rectum were excluded. After plain film evaluation, thin barium was instilled through Foleys catheter under fluoroscopic guidance. Rule of 3 was followed and reduction was considered successful when contrast refluxed into terminal ileal segment. Follow up plain x-ray and ultrasound was done after 48 hours to rule out recurrence. Hydrostatic reduction was successful in 18 out of 21 patients collected during last five years. Reduction was incomplete in one case while perforation was observed in 2 cases. These complications were observed in the largest group [52%] of patients reporting on 3rd day of onset of symptoms. A significant number [38%] of patients reached the hospital within 48 hours. Only 2 [10%] patients presented in first 24 hrs but uneventful reduction was possible in later two groups. Careful hydrostatic reduction in cases of ileo-colic intussusception reporting within 72 hrs will reduce hospital stay and patient morbidity in most of the cases

Scarred uterus; frequency of placenta praevia

To study frequency of Scarred Uterus in placenta praevia. Descriptive observational study. December 2008-December 2009 Holy family Hospital Rawalpindi. 50 patients with placenta praevia presented to Holy Family Hospital Gynae and Obs unit II during this period. All patients either admitted through emergency or Gynae outpatient department were included. The mean age of patients with placenta Praevia was 29.04 year with [SD =5.11].The mean gestational age was 34.6 weeks and [SD = 2.7]. Fourteen [28%] patients were gravida 2 and 13[26%] were primigravida. Fifteen [30%] patients were para 1 and 14 [28%] were para 0. Painless vaginal bleeding was the presenting complaint in 38[76%] patients, whereas 12[24%] patients were diagnosed on routine ultrasonography. Nine [18%] cases underwent spontanouse vertex delivery and 41 [82%] cases were delivered by caesarean section. Placenta Praevia type 1 in 7 [14%] cases. Placenta Praevia type 2 in 20 [40%] cases, type 3 in 14 [28%] cases, type 4 in 9 [18%] cases. Previous history of scarred uterus was found in 16 [32%] cases .Post partum haemorrhage occurred in 13 [26%] cases .caesarean hysterectomy in 5 [10%] cases. A scarred uterus leads to increase frequency of Placenta Praevia, scarring of uterus can be reduced by keeping the caesarean section rate within reasonable limits and instead of doing surgical evacuation of retained products of conception, suction and evacuation by suction canula

Etiology and pattern of swellings in mandible and maxilla

To determine the etiology and pattern of swellings in the mandible and maxilla. A descriptive study. This study was conducted at Oral and Maxillofacial Surgery Dept, Armed Forces Institute of Dentistry Rawalpindi for two years from December 2004 to December 2006. Three hundred and fifty patients with swellings in the jaws reporting to AFID were included in this study. After history, clinical examination and radiographic evaluation, patients were registered. All patients whether admitted to hospital or treated as outdoor patients in oral surgery clinic were included. Swelling of the parotid region, nasal and para nasal sinuses and neck were not included. In majority 131 [37.42%] the patients were of age between 21 to 30 years [mean 25.5 years]. Males were affected more than females with ratio 1.3:1. The most common swellings found were inflammatory which accounted for 138 cases [39.42%] due to odontogenic reasons i.e. caries and non vital teeth. The most frequent site involved was mandible which accounted for 202 cases [57.71%]. In 111 cases [31.71%] the treatment modality used was incision and drainage followed by antibiotics. Caries and non-vital teeth were cause of the most common inflammatory swellings. The predominant site of swellings was the mandible. Every person must visit a dentist for oral examination six monthly so that early lesions in mandible and maxilla can be detected and treated more conservatively

Glomus tumors

Glomus tumours of the temporal bone occur in the region of the jugular bulb middle ear. They are rare, highly vascular, slow growing tumours and most are benign. Tumours that originate from the jugular bulb and extend to involve the middle ear are referred to as glomus jugular tumours. Those that are found in the middle ear around the otic ganglia in the tympanic plexus are known as Glomus tympanicum. Yhese tumours occur predominantly in women in the fifth and sixth decades of life. Because of the insidious onset of symptoms, these tumours often go unnoticed and there is often a significant delay in diagnosis. Morbidity in these cases is determined by their size and position. 1. To study the age/sex incidence of patients suffering from glomus tumours of the temporal bone. 2. To see various clinical presentations with which these tumours present and their variation according to the age and sex. Our study design was non-inter-ventional descriptive. This study was performed at CMH Rawalpindi and Multan from January 2000 to June 2002. We included ten patients of glomus tumours of the temporal bone in our study. 8 out of these were females and two were males. Though most of the patients belonged to middle age group yet few were also from the younger and older groups. All the patients underwent CT scan with and without contrast, MRI of the requisite site and carotid angiography. We found that these tumours were predominantly present in females, mostly in the middle age group. Individual symptoms were studied in detail and their presence was found to be directly proportional to the increasing age of patients. It is concluded that due to the slow growth of this tumour the diagnosis is often delayed until it is extensive. Therefore clinicians should be more vigilant about this rare disease and must keep it in their differentials