Role of deliberate creation of control enterocutaneous fistula in patients of abdominal tuberculosis with perforation of small bowel and matted small intestine

To study the results after forming the controlled enterocutaneous fistula in the patient of abdominal tuberculosis with matted and perforated small bowel. Design, place and duration of study This study based on therapeutic trial and conducted in one and half years from january1999 to june2001 at Mayo Hospital, Lahore. All these 20 patients either operated in emergency or on elective list were malnourished, toxic and their operative findings were almost the same, these patients had extensively matted, friable and perforated gut. In these patients it was technically not possible to perform some definite procedure like right haemecolectomy or ileostomy with out increasing the morbidity or mortality. Under these circumstances, minimal surgical procedure which can be life saving is to oppose the anterior abdominal wall to the perforation and thus create a controlled enterocutaneous fistula. In 11 patients fistula closed on its own and in eight patients fistula remained patient and needed re-exploration and repair. This new method of treatment has yielded excellent results. We were able to cure the disease with no mortality. It is recommended that in cases of TB peritonitis with perforation and matted gut making of a controlled enterocutaneous fistula saves the life of the patient

Chemical composition of urinary stones in Rahim Yar Khan and adjacent districts of Sindh and Baluchistan

To find out the constituents of the urinary stones, so that preventive measures would be taken against recurrence. A total No. of 200 consecutive patients with upper urinary tract calculi, that were operated in the urology and general surgical wards of Sh. Zayed Hospital Rahim Yar Khan were included in the study. In addition to Rahim Yar Khan the patients also came from adjacent districts of Sindh and Baluchistan. Qualitative Chemical analysis was carried out using Merchognost [Germany] urinary calculi analysis kit. All the tests were performed according to the instruction of manufacturers of the kit. Stone samples were collected from 200 patients, out of these 138 [69%] were male and 62 [31%] of patients were female with male to female ratio 2.2:1 age range was between 9-72 years. Results of stone analysis indicate that calcium oxalate is the most common ingredient found in 100% of the stone samples. In 83% of patients it was found mixed with other varieties of stones while in 17% samples it was seen in pure form. Uric acid was the second most common ingredient seen in 73% of patients mixe d with calcium oxalate and magnesium ammonium phosphate but it was not found as pure form. Magnesium Ammonium phosphate found in 13% of stones samples in mixed form only, not as isolated stone