Urodynamic bladder patterns in spinal cord injury patients

Objective: To determine the frequency of various neurogenic bladder patterns in patients with traumatic spinal cord injury presenting at Armed Forces Institute of Rehabilitation Medicine Rawalpindi based on urodynamic studies

Study Design: Descriptive cross sectional study

Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine [AFIRM] Rawalpindi, from Jul 2014 to Jun 2016

Material and Methods: One hundred and forty traumatic spinal cord injury patients fulfilling the inclusion criteria were included both from indoor and outdoor departments through non-probability purposive sampling. Urodynamic studies were performed using the urodynamic equipment at urodynamic laboratory. Data were collected and recorded on specialized proforma by the principal investigator

Results: Among 140 study participants detrusor overactivity was found in 100 patients out of which 76 [76%] had thoracic level of injury, 20 [20%] had cervical level and 4 [4%] had lumbar level of injury. Detrusor areflexia was the bladder pattern in 40 patients out of which 26 [65%] had thoracic level of injury, 10 [25%] had cervical level, and 4 [10%] had lumbar level of injury

Conclusion: Detrusor overactivity was the commonest neurogenic bladder pattern among the traumatic spinal cord injury patients

Hysterosalpingographic evaluation of primary and secondary infertility

To determine the pathological patterns of fallopian tubes and uterus on hysterosalpingogrphy [HSG] examination in cases of infertility. Two years retrospective charts review of patients referred to our centre for HSG evaluation of infertility, from July 2008 to July 2010. Four thousand one hundred eight hysterosalpingograms were carried out at our centre during the study period. Out of these, 1999 [48.6%] were primary infertility cases while the 2109 [51.3%] were of secondary infertility. Mean age of presentation for primary infertility was 30 years and 35 years for secondary infertility. Bilateral free peritoneal spill was noted in 60% of cases. Unilateral tubal blockage was present in 15% and bilateral tubal blockage in 10% of patients. Bilateral hydrosalpinx was present in 10% of patients and unilateral loculated spill was found in 5% of patients with primary infertility. Patients with uterine congenital anomalies were also evaluated and the frequency of bicornuate uterus was 4%, unicornuate uterus was 2% and uterine didelphys was 0.2%. Infertile patients who underwent HSG were mostly in older age group with secondary infertility being slightly more common emphasizing early work up and care. Most of the patients with primary infertility had normal HSG examination. To our knowledge this is the largest data for HSG to be presented from Pakistan

Increased incidence of adrenal gland injury in blunt abdominal trauma: a computed tomography-based study from Pakistan / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To determine the frequency of adrenal injuries in patients presenting with blunt abdominal trauma by computed tomography (CT).</p><p><b>METHODS</b>During a 6 month period from January 1, 2011 to June 30, 2011, 82 emergency CT examinations were performed in the setting of major abdominal trauma and retrospectively reviewed for adrenal gland injuries.</p><p><b>RESULTS</b>A total of 7 patients were identified as having adrenal gland injuries (6 males and 1 female). Two patients had isolated adrenal gland injuries. In the other 5 patients with nonisolated injuries, injuries to the liver (1 case), spleen (1 case), retroperitoneum (2 cases) and mesentery (4 cases) were identified. Overall 24 cases with liver injuries (29%), 11 cases with splenic injuries (13%), 54 cases with mesenteric injuries (65%), 14 cases (17%) with retroperitoneal injuries and 9 cases with renal injuries were identified.</p><p><b>CONCLUSION</b>Adrenal gland injury is identified in 7 patients (11.7%) out of a total of 82 patients who underwent CT after major abdominal trauma. Most of these cases were nonisolated injuries. Our experience indicates that adrenal injury resulting from trauma is more common than suggested by other reports. The rise in incidence of adrenal injuries could be attributed to the mode of injury.</p>

Primary mediastinal germ cell tumor successful curative resection following chemotherapy a case report

Primary mediastinal germ cell tumours are relatively rare and account for only a small portion of all the mediastinal tumours. We present a case of a primary mediastinal germ cell tumour in a 14 years old Afghani boy