RESUMEN
Objective: To determine the surgical outcomes of total laparoscopic hysterectomy performed
Study Design: Case series
Place and Duration of Study: Obstetrics and Gynecologic Endoscopic Unit of Patel Hospital, Karachi, from February 2013 till February 2016
Methodology: The study included all patients on whom total laparoscopic hysterectomy was performed during the study period. Patients with malignancy were excluded from the study, except those with suspected stage 1 and 2 endometrial carcinoma. The procedures were performed by two gynecologists keeping rest of the team constant, with similar technique. The reviewed outcome measures were duration of surgery, and intraoperative and postoperative complications
Results: Out of 209 patients, majority were multiparous with median age and weight of 45 [50-40] years and 69 [80-60] Kgs, respectively. Previous history of abdominopelvic surgery was present in 33%. Heavy menstrual bleeding was the leading indication. Median and interquartile value of operative time was 175 [225-120] minutes. Total rate of intraoperative and postoperative complications was 12.9% and major complications were 3.8%. All postoperative complications were minor. Of all, 3.3% of patients were converted to open surgery; there was no vascular injury or re-operation
Conclusion: Total laparoscopic hysterectomy is safe, acceptable, and doable alternative to conventional standard hysterectomy
RESUMEN
To estimate blood lead level [BLL] and to assess the features of lead toxicity among lead acid battery [LAB] industrial workers. This prospective study was carried out in the medical centre of PCSIR Laboratories, Karachi from March 2012 - March 2013. Fifty LAB industry workers, males and females between 17-65 years were included in the study. They were divided into group 1 with 40 workers- directly related and group 2 with 10 workers -indirectly related, [administration staff members] to LAB manufacture. Detailed history, complete physical examination and BLL estimation by flameless atomic absorption spectrophotometer was done. Total 34 patients in group 1 and 3 patients in group 2 had elevated BLL. Comparison of group 1 and 2 revealed anemia [40v/s4], bone pain [38v/s7], abdominal pain [38 v/s 2], nausea [32v/s6], head ache and irritability [24v/s6], weakness and lethargy [21v/s6], tremors [13v/s0] insomnia [5v/s4], lead line [4v/s 0] and blood pressure above 140/90 mm of Hg [12v/s0] respectively. High blood lead level and features attributable to lead toxicity were prevalent among LAB industry workers of Karachi
RESUMEN
An oil tanker, Tasman Spirit, carrying 67000 tons crude oil, got damaged near the Clifton Beach of Karachi, Pakistan and approx. 31,000 ton oil spilled into the sea. The distribution of aliphatic and aromatic hydrocarbons was determined in deep sea and surface sediment collected at 12 stations along the Clifton beach of Karachi, following the oil spill. Sampling was performed during 2003-2006, starting just after the accident of the oil tanker. Concentrations of PAHs [116 parent components] and aliphatics were in the range of 0.09-560 ng/kg dw and 0.12-685 |ug/kg dw, respectively, since the date of accident and after bioremedial measures. The highest concentrations were found within the radius of 50 km around the site, the area most heavily impacted by the spill, whereas at the stations, away from the ship, the concentrations were in the lower range without alkylated compounds. Addition of increasing amounts of ship fuel oil [taken from a Pakistani ship] to a representative sediment sample showed that measurable concentration of the Tasman Spirit oil was > 1 g/kg of sediment. The toxicity of selected samples of surface sediment from the coastal area near oil spill showed higher PAH concentrations; the average number of dead fauna was 90-95% within 3 days of oil spill which gradually decreased with the time
RESUMEN
Stress echocardiography has emerged as an important tool for non-invasive assessment of coronary artery disease [CAD]. Exercise and dobutamine stress echocardiography [DSE] are frequently used modalities with distinct clinical indications and procedural variations. We report our findings on these two tests comparing various aspects and outcomes. Four hundred seventy one consecutive patients underwent SE at Sheikh Zayed Hospital Rahim Yar Khan. Exercise Echo [Ex.E] was performed on treadmill using Bruce's protocol. DSE performed in standard method. SE was considered as positive with the appearance of new or worsening wall motion abnormality. Ex.E performed by 300 patients and DSE 171 with mean age of 48.09 and 54.92 respectively. Males were dominant in both groups. The risk factors were almost same in both groups. Ex.E was more performed for diagnosis of CAD than DSE [59% vs 25%]. Viability testing was exclusively done by DSE. Post revascularization status was assessed in 10% and pre-operative assessment for non cardiac surgery in only 2%. Incidence of side effects was 26% in DSE and none in Ex.E. The double product was greater in Ex.E. Positive tests were reported in 43% and 33% in DSE and Ex.E respectively. Stress induced LV dysfunction was more common in DSE. Comparing available coronary angiograms, single vessel disease was better detected by DSE [60% vs 46%]. Double vessel disease was relatively higher in Ex.E [35% vs 28%]. Ex.E is safer and better non invasive diagnostic imaging modality in patients who can perform physical exercise, however DSE is more useful for viability, pre-operative evaluation and patients physically disabled for treadmill or ergometer exercise test