Infected textiloma, 35 years after the operation for femur fracture, an extermly rare occurance

Retained gauze after surgery is an uncommon error and it may be associated with many complications. We are reporting our case to call attention to the fact that retained gauze may become symptomatic even after a very long interval. Herein we report on a patient who developed infection and fistula with discharge from this error 35 years after a surgery for femur fracture and insertion of a IM nail. The diagnosis was easily made because of a marker in the gauze. Removal of the gauze and irrigation and debridement of the wound in two stages led to complete recovery of the patient as was shown in the 1 year follow up. Retained gauze after surgery is a preventable complication and may be asymptomatic for a very long period, but can become a complication post-operatively at any time. Hence, if diagnosed immediately after the surgery or at any other time, the gauze should be removed

Value of kidney-ureter-bladder radiography in the erect position in addition to standard intravenous urography examination

To determine if additional kidney-ureter-bladder radiography in the erect position can improve the diagnostic yield of standard intravenous urography [IVU] examination. This prospective study was conducted from March to July 2007 on 108 consecutive patients [65 males and 43 females, age ranging from 20 to 50 years] who were referred to the Department of Radiology, Al-Amiri Hospital, Kuwait, for IVU examinations. After 15 min, a film was done in the erect position in addition to the routine IVU protocol. Additional information was demonstrated in the erect radiograph as follows: detecting nephroptosis in 18 [17%] patients, improved visualization of the ureters in 58 [54%] patients, and differentiation between phleboliths and ureteric stone was possible in 12 [11%] patients. Our study demonstrated significant additional findings in the erect position [at 15 min] compared to the supine position

Early complications in the operative treatment of ankle fractures

We reviewed early complications of 35 surgically treated closed ankle fractures at Services Hospital, Lahore between January 1993 to January 1994. There were 28 males and 7 females with age ranging from 16-80 years. Webers AO Method of classification of fractures was used. There were 23 Weber type B and 12 Weber type C cases. Fracture dislocations were three times more common than simple fractures. The complication rate was 28.5%, with two major and eight minor complications. Fractures with blisters and skin abrasions had more than double the overall complication rate. Patients not fixed within 24 hours had 44% major complication rate compared to 5-3% in those operated upon as emergencies. We conclude that operative treatment of ankle fracture must be carried out in a timely fashion, especially in severe fractures. Fracture dislocations and delay in surgery are the major factors responsible for higher complication rate

Treatment of hirsutism in polycystic ovarian syndrome with diane, 50MCG ethinyl estradiol and 2MG cyproterone acetate

The value of Diane in the treatment of hirsutism in polycystic ovarian syndrome was assessed subjectively and objectively in a double blind trial in 20 women studied for one year. The menstrual frequency was recorded. Circulating levels of testosterone, dihydroepiandrosterone sulphate [DHEASO4], FSH, LH and pelvic ultrasonography was done before treatment and after 3, 6 and 12 months of therapy. Significant beneficial effects of the treatment were noted in nearly 70% of the cases. 20% cases required additional therapy and 10% failed to respond. Minimal side effects were observed. Withdrawal bleeding was irregular and scanty with Diane but the levels of LH, testosterone, DHEASO4 and estrogen were decreased to within normal limits with the disappearance of the typical polycystic ovarian picture on ultrasonography