Augmentation rhinoplasty with autologus iliac crestbone graft

Objectives: To study merits and demerits ofautologus iliac crest bone graft in augmentationrhinoplasty

Study Design: Descriptive

Setting:ENT Department Allied Hospital Faisalabad

Period:From Jan 2007 to Dec 2011

Material AndMethods: The majority of patients were admittedthrough ENT out patient department. The data wascollected on the basis of history, physicalexamination, investigations photography,management and follow up

Results: Total 50patients 30 males 60% and 20 females 40%. Themajority of patients were from 3rd decade of life 70%.The duration of deformity in majority of patientswas with in 2 years [60%]. In all patients indicationfor augmentation rhinoplasty was cosmetic [100%].The autologus iliac crest bone graft was used in allpatients [100%]. The etiological factor for saddledeformity in majority of cases was trauma [50%].The donor site morbidity was [16%]. Overallsuccess rate was [98%]. Revision surgery was notdone in any case

Conclusion: The autologus iliaccrest bone graft has excellent outcome inaugmentation rhinoplasty with minimal

Role of fiberoptic bronechoscopy in the diagnosis of lung diseases: an experience with 164 cases

The aim of this cross sectional study is to determine the role of fiberoptic bronchoscopy in the diagnosis of lung diseases and observe the clinical presentation, diagnosis, complications and demographic characteristics of the patient in Jinnah Hospital Lahore. The study was performed in the Department of Pulmonology, Jinnah Hospital/Allama Iqbal Medical College Lahore from January 2007 to June 2008. This study was completed on 164 patients who underwent bronchoscopy for various reasons. The data was analysed on the basis of demography, clinical symptoms, radiological and bronchoscopic findings, type of specimen taken, and their microbiological and histopathological reports for definite diagnosis. A total of 164 patients underwent bronchoscopy during this period. Among these 99 [60%] were males and 65 [40%] were females. Age of the females ranged from 16-70 years with mean 48.5 +/- 13.2 and the males were from 14-85 years with mean age 57.8 +/- 18.1. Fifty eight [35.4%] were non smokers whereas 106 [64.6%] were smokers. Among them 63 [38.4%] presented with cough while 37 [22.5%] with cough and fever and 23 [14.0%] with chest pain. Hoarseness of voice was present in 6 [3.7%] and 35 [21.3%] presented with haemoptysis. Right lung involvement was observed in 74 [45.2%] and left lung in 52 [31.7%], whereas bilateral involvement was observed in 30 [18.3]. On bronchoscopy in 84 subjects, fungating mass was present in 30 [18.2%], infiltrative lesion was observed in 10 [6.8%], nodular mass was seen in 8 [4.7%], thick pussy secretion was obtained in 25 [15.1%], external compression was found in 05 [3.0%] subjects and vocal cord paralysis was present in 06 [3.6%]. Among 164 patients we were able to reach a definite diagnosis in 109 [66.4%]. There was no complication in 140 [85.4%] patients, while mild haemoptysis was present in 7 [4.3%], 13 [8%] had low grade fever and 4 [2.4%] developed bronchospasm. Bronchoscopy is a safe procedure for the diagnosis of bronchogenic carcinoma and also for smear negative pulmonary tuberculosis. The incidence of complication is also very low in experienced hands

Acute myocardial ihfarction; serum magnesium and electrolyte levels at presentation in emergency department

Magnesium, the second most abundant intracellular cation have several critically important roles in human body. In addition to energy production and maintenance of electrolyte balance, magnesium [Mg[++] is essential for normal neuromuscular function, excitation contraction coupling maintenance of vessel tone, blood coagulation as well as Ca[++] and K[+] transport across the plasma membrane. Case control study. Atotal of 125 subjects enrolled for this study, 88 were AMI patients having their first episode. 37 subjects were taken as control group. These patients were classified into three groups depending on the age of the subjects. To find out serum magnesium and electrolyte levels in AMI patients at presentation to Emergency Department. Hypomagnesaemia is a common clinical finding in cases of acute myocardial infarction at their presentation to the emergency department of Punjab Institute of Cardiology, Lahore. It is very critical as ventricular tachyarrythmias cardiac arrest, sudden cardiac death, re-infarction are the usual outcome. There is Hypomagnessemia [P<0.001] in all the subgroups while for Na[+] and K[+] [P>0.05]. Our result explains the contribution of hypomagnesaemia as a minor risk factor for AMI. Therefore it is suggested that serum magnesium should be estimated in each case of AMI patient. Importance may be given to Mg[++] supplementation where needed. The dosage should not be empirical but be based on individual patient requirement

Cervicofacial emphysema

The case describes a young girl developing cervicofacial emphysema after fall. She presented in emergency with gradually worsening upper body swelling without any sign of distress. Swelling was found on the right side of the face, all around the neck and right arm with crepitus in all these areas. CT scanning of head, neck and chest were performed and a small area of communication between nasopharynx and the trapped air of subcutaneous emphysema was seen. Video-endoscopy of the pharynx showed a tear in the nasopharyngeal mucosa acting as a one way valve leading to the development of cervicofacial emphysema

Pulmonary alveolar microlithiasis

This is a case report of 32 years old male, who presented in outdoor clinic of Pulmonology Department, Jinnah Hospital, Lahore, with progressively increasing shortness of breath over 2 years, multiple episodes of dry cough over 9 months, history of low-grade fever for 15 days and haemoptysis for the last one day. He was diagnosed as a case of miliary tuberculosis on the basis of his chest X-ray findings and was on anti-tuberculosis treatment by the GP of the locality. Diagnosis of pulmonary alveolar microlithiasis was made on the basis of clinical features and laboratory findings

study of the relationship between body fat distribution and development of hypertension in postmenopausal women

75 Pakistan females were involved in this study. They were divided into three groups each consisting of 25-females. The premenopausal group was taken as control group and other two were experimental groups known as early postmenopausal and late postmenopausal groups. To evaluate the role of body fat distribution in the prediction of atherosclerotic changes leading to coronary heart disease and stroke syndrome in postmenopausal women. The study was carried out in the Department of Physiology at Postgraduate Medical Institute, Lahore. August 1999 to October 1999. Seventy five Pakistan females were involved in this study observing specific inclusion and exclusion criteria. Each group was composed of twenty five subjects. Detailed history was taken on printed proforma with clinical examination. Waist to hip ratio was calculated by the waist and hip circumference measurement in centimeters. The weight was measured by weighing machine. Comparisons were made between mean values of physical parameters with the following schemes: 1. Premenopausal group v/s early postmenopausal group; 2. Premenopausal group v/s late postmenopausal group; 3. Early postmenopausal group v/s late postmenopausal group. It was noticed that weight was significantly altered [P < .001] in two comparisons and the WIIR was significantly changed [P < .001] in all the three comparisons. Waist to hip ratio was known to be sensitive marker to atherosclerotic lesions in comparison with simple weight measurement

Incidence of myopia in school going children in Rahim Yar Khan

Myopia is becoming a major health problem all over the world. To assess the incidence of myopia among school children and to determine the association of genetics, nutrition and close work to myopia. Prospective study. In Rahim Yar Khan district. Period: From Feb 2006 to June 2006. We conducted a cross sectional survey among school children of 8-15 years age. There was 300 children in this study from two school. They were checked for visual acquity and nutritional status after taking a complete personal and family history. Any student detected to have myopia was then brought to eye outdoor for further specialized check up and evaluation. A total 57 students [19%] were found to have myopia in school going children in Rahim yar Khan between ages 10-15 years. The genetic factor was present in 91% of myopes [P<0.001]. The average amount of near work after school in myopes was considerably more than the emmetropes P<0.05 for study and P<0.005 for recreational books. Regarding nutritional status, 30% myopes were mainourished whereas similar percentage of emmetropes was malnourished. In our study heredity was closely associated with myopia. The children in both groups [the myopes and emmetropes] did almost equal amount of near work for their studies but myopes spent more time in reading for pleasure than emmetropes who took more pleasure in out door sports activities. The nutritional status of children was not associated with incidence of myopia in our study

Postmenopausal women; atherosclerotic risk factors

Postmenopausal women are more prone to develop cardiac morbidity due to exhaustive production of estrogens. Postmenopausal women may have 3-4 fold greater risk of atherosclerosis after a natural menopause. To find correlation between biochemical and physical parameters after the onset of menopause and their effects on disease process in the postmenopausal women. Prospective Study. PGMI Lahore. Period: From Jan 2000 to Oct 2000. 75 subjects were enrolled in this study and divided into three groups i.e. premenopausal [control], early postmenopausal and late postmenopausal groups. Their physical parameters like weight, waist to hip ratio [WHR] and blood pressure were taken. Biochemical parameters, like cholesterol, triglycerides, high density lipoprotein cholesterol [HDL-C] and low density lipoprotein cholesterol [HDL-C] were estimated by commercial scientific kits. Biochemical parameters were mostly non-significant changed [P > 0.05] while physical parameters were deviated significantly [P < 0.001] when comparisons were made between mean values of various study groups. Even at normal values of lipid profile, the postmenopausal women are at risk of developing atherosclerotic lesions because of hypertension, obesity, exhaustive production of estrogen and android type of body fat distribution