Résumé
Background: Prostate cancer incidence is rising leading to a major health problem globally. Infectious complications in TRUS guided prostate biopsy are very common without antibiotic prophylaxis
Objective: To compare the effect of single dose and three day ciprofloxacin prophylaxis regimen for prevention of urinary tract infection after prostatic biopsy
Methodology: This randomized controlled trial involved 130 patients with Prostate cancer which were randomly allocated into 2 groups. Group-A received two ciprofloxacin 500 mg tablets stat while Group-B received 3 days has of ciprofloxacin treatment. Patients were followed up to 5 days to observe any symptoms of UTI. Written informed consent was taken from all the patients. The data was entered and analyzed using SPSS version 19
Results: The mean age of the patients was 56.84 +/- 7.28 years. The mean age of the patients in Group-A was 56.44 +/- 7.10 years while in Group-B it was 57.23 +/- 7.50 years. However, there was no statistically significant difference between groups in terms of age. On follow up at 5 days, 11 patients has UTI. The rate of presence of UTI was similar across different age groups and treatment regimens. Treatment with one-day antibiotic prophylaxis resulted in UTI in 6[9,2%] associated with in comparison to three days' antibiotic treatment, where 5 [7.6%] has UTI. [P=0.64]
Conclusion: The incidence of UTI with one-day antibiotic prophylaxis with ciprofloxacin was comparable to three antibiotic treatments in patients who are candidates for TRUS guided biopsy
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Background: Hypospadias is a congenital abnormality characterized by opening of external urethral meatus on ventral aspect of the penis with an overall incidence of 1:300. Different treatment modalities have been employed in the treatment of distal penile hypospadias with varying degrees of success and complications. A number of studies have compared Mathieu and Snodgrass Techniques but the existing evidence is doubtful owing to small sample size and great variation in their results
Objective: To compare the outcome of Mathieu repair with that of tubularized incised Plate Urethroplasty [Snodgrass] in distal penile hypospadias
Methodology: 90 patients meeting the inclusion and exclusion criteria's were selected and divided into two equal groups randomly using lottery method. Group-A was treated by Mathieu technique and Group-B underwent Snodgrass repair. Operative time was noted in minutes from the start of procedure till the end. Patients were followed post-operatively at 15[th] day, 1 Month and 2 Months and functional recovery and complications were evaluated
Results: The age of the patient ranged from 1 to 25 years in both groups with mean age of 6.67+/-5.74 years in Group-A and 6.65+/-6.06 years in Group-B [p=0.982]. Snodgrass was better in terms of mean operative time [67.37+/-8.85 minutes versus 87.86+/-8.22; p=0.00] as compared to Mathieu technique. The functional outcome in terms of meatal location at tip was better in Snodgrass [93.7% versus 80.2%; p=0.003] with a lower fistula rate [5.4% versus 21.6%; p=0.00] as compared to Mathieu technique
Conclusion: Tubularized Incised Plate Urethroplasty [Snodgrass] is better than Mathieu technique for the treatment of distal penile hypospadias in terms of operative time, success and complication rate
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Objective: To determine the frequency of true positive cases in staging of renal cell carcinoma on computed tomography[CT] tacking histopathology as gold standard
Methods: 75 patients diagnosed as RCC on CT underwent nepherectomies and histopathological / radiological staging were compared
Results: The overall sensitivity of CT for diagnosing RCC was 93.33%. For T1a 100%, for T1b 51.7%, for T2 80%, for T3a 75%, for T3b 2% and for T4 100%. The sensitivity for N1 and N2 is 66.67% and 80.2% respectively. CTshowed higher stage in 43.3% cases
Conclusion: Computed tomography is still a good diagnostic modality for pre-operative staging of RCC and planning of surgery
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The hyperlipidemia is a life style disorder and has affected mankind since antiquity. Detailed work has been carried out to reduce the burden of this disease and many drugs have been proposed in different systems of medicine to overcome the situation and to minimize complications. Unani system of medicine also has significant contribution in this regard and a number of studies are going on for the same. Here, it is aimed to explore the possible concept of hyperlipidemia in Unani system of medicine. A disease Siman-i-mufrat is discussed in ancient Unani literature, which has many similarities with hyperlipidemia. Hyperlipidemia is a major health problem in entire world and responsible for the development of atherosclerosis and hence in coronary artery disease and many fatal conditions. The Unani system can provide a valuable contribution towards reduction of the disease development and help to decrease its complications. In Unani system of medicine, the concept of fat or oily substance in blood is present and was narrated as Dasoomat-fid-dam
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Objective: the objective of this study was to assess the perceptions of undergraduate medical students of Services Institute of Medical Sciences [SIMS], using DRE EM questionnaire
Material and Methods: all students from the final year MBBS class of the medical college [n=150] were included in the study. The non-parametric chi-square test and Mann Whitney U Test were used to determine the significance of differences [proportion of frequencies] for individual items
Results: the total no of final year students of medical college were 150 with 135 respondents with 43% males and 57% females. DREEM score SIMS medical college in metropolitan city was 118.6 indicating a positive perception
Conclusion: DREEM is a valid instrument for the measurement of students' perceptions worldwide. The students of SIMS have positive perception about educational environment of the institute
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Backgroud: Liver is an important metabolic organ. It has wide range of functions including detoxification, storage of glycogen, vitamins A, D and B12, production of several coagulation factors, growth factors such as insulin-like growth factor-1 (IGF-1), angiotensinogen, and biochemicals necessary for digestion (bile). Its damage occurs due to its multidimensional functions, various xenobiotics and oxidative stress leading to distortion of all of its functions. Oyster mushroom which is excellently edible and nutritious has got free radical scavenging activity, and so may be considered as a hepatoprotective agent. Objective: To observe the hepatoprotective effect of Oyster mushroom (Pleurotus florida) against paracetamol induced liver damage in Wistar albino rats. Materials and Methods: This experimental study was carried out in the Department of Physiology, Sir Salimullah Medical College (SSMC), Dhaka from 1st July 2009 to 30th June 2010. Thirty four Wistar albino rats, aged 90 to 120 days, weighing between 150 to 210 grams were used for the study. After acclimatization for 14 days, they were divided into two groups –– control group (Group A) and experimental group (Group B, mushroom-pretreated and paracetamol-treated group). Control group was again subdivided into Group A1 (baseline control group) and Group A2 (paracetamol-treated control group). Animals of all groups received basal diet for 30 consecutive days. In addition, Group A1 rats received propylene glycol (2 mL/kg body weight orally) only on 30th day, Group A2 rats received single dose of paracetamol suspension (750 mg/kg body weight orally) only on 30th day and Group B rats received mushroom extract (200 mg/kg body weight orally) for 30 consecutive days and paracetamol suspension (750 mg/kg body weight orally) only on 30th day. All the animals were sacrificed on 31st day. Then liver specimens were collected. Histology of liver was done by using standard laboratory procedure. Statistical analysis was done by one way ANOVA test by using SPSS version 15.0. Result: In this study, histological examination of liver reveals abnormal histological findings in 100% of rats in paracetamol-treated group (Group A2), almost normal structure in 80% of rats and mild histological changes in 20% rats in mushroom-pretreated and paracetamol-treated group (Group B). Conclusion: The present study reveals the hepatoprotective effect of Oyster mushroom (Pleurotus florida) against paracetamol induced liver damage in Wistar albino rats.
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OBJECTIVE: To determine the frequency of Malnutrition Inflammation Complex Syndrome [MICS] in patients with End Stage kidney disease on maintenance hemodialysis patients presenting to tertiary care Hospital in Karachi
DESIGN: A cross sectional study
SETTINGS: Department of Nephrology Jinnah Postgraduate Medical Center, Karachi
METHODS: Total of 62 patients was included through non-probability purposive sampling
All patients diagnosed with End stage kidney disease on maintenance hemodialysis [twice week for >3months] were included and patients with acute kidney injury, chronic infections and chronic liver disease were excluded. Malnutrition inflammation score [MIS] was used to determine malnutrition inflammation complex syndrome [MICS]. Mean and standard deviation were calculated for continuous variables, and percentages or proportions for categorical variables
Chi square test was used to determine the proportion of MICS in Maintenance Hemodialysis patients
RESULTS: Mean age was 46 years +/-12.59 SD [range 18-72 years]. 34 [55%] were females and 28 [45%] males. 26 [42%] patients had duration of Maintenance Hemodialysis<1 years and 28[45%] between 1-4 years. Frequency of malnutrition complex syndrome [MICS] in patients with end stage renal failure was noted in 60 [97%] patients, out of these 31[50%] patients had mild MICS and 29 [47%] patients moderate MICS. Mild and Moderate malnutrition complex syndrome [MICS] was more observed in age group of 31-40years [12% in mild and 14% in moderate [MCIS].Moderate MICS was higher in females and mild MICS was higher in male patients
CONCLUSION: Our study concluded that most [97%] of our patients with end stage kidney disease on maintenance hemodialysis has evidence of malnutrition inflammation complex syndrome
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The present study demonstrates the biological activity of Ochthochloa compressa, since extensive literature survey has shown no documented biological activity of this plant. Ethanolic extract of whole plant was prepared and evaporated under reduced pressure by rota vapor
The crude extract was further fractionated into n- hexane, dichloromethane, ethyl acetate and n-butanol soluble fractions
These fractions were screened for antifungal, phytotoxic, cytotoxic and antibacterial activities
Dichloromethane soluble fraction showed significant phytotoxicity whereas n-hexane, ethyl acetate, and n-butanol soluble fractions showed non-significant phytotoxicity
Similarly, ethyl acetate soluble fraction was the only fraction, which showed significant cytotoxic activity
There was no antibacterial but moderate antifungal activity was shown by these fractions against selected strains of bacteria and fungi. This is the first report on the biological activity of O. compressa
Résumé
Objective: To determine the frequency of cutaneous changes in patients with chronic kidney disease on maintenance hemodialysis
Methods: A cross-sectional study conducted at Department of Nephrology, Jinnah Postgraduate Medical Centre, Karachi from 1[st] August 2009 to 31[st] January 2010. A total of 100 patients with chronic kidney disease on maintenance hemodialysis were included. After taking demographic data, cutaneous changes were noted. Mean and standard deviation were computed for quantitative variables [age] and frequency and percentage were computed for categorical variable [sex, cutaneous changes]
Results: Mean age was 52.58+/-13.84 years and out of 100 patients 56% were males. At least one skin change was noted in 91%. Among type of manifestations, xerosis was noted in 96%, generalized xerosis 70%, alopecia 70%, half-and-half nails 36%, scaling 20% and ichthyosis 10%. Pruritus was found in 64%, out of these 93% had mild to moderate intensity and 7% had severe intensity of pruritus
Conclusion: Chronic kidney disease is associated with a complex array of cutaneous manifestations caused either by the disease or by treatment. Xerosis and pruritus were most common among patients with CKD, so early recognition of cutaneous signs can relieve suffering and decrease morbidity
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Background: Enlarged palpable cervical lymph nodes as a primary presenting sign are very common and may be due to inflammatory lesions and tumors. Correlation between clinical findings and laboratory data is essential in arriving at a diagnosis. In patients presenting with cervical lymphadenopathy, excision biopsy provides material to establish an early diagnosis. We designed this study in our population for histological evaluation of cervical lymph node biopsies that might be important in the management of these patients. Objective: Histopathological evaluation of different diseases involving the cervical lymph nodes in relation to age and sex of the study population. Materials and Methods: It was a cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. A total of 107 patients were evaluated for specific cause of cervical lymphadenopathy in relation to age and sex. Lymph node biopsies of all patients of both sexes and all age groups were included in the study. Results: Among the 107 subjects 58 (54.2%) were males and 49 (45.8%) were females with a male to female ratio of 1.2:1. The age of the patients ranged from 2 to 85 years with a mean age of 32.68 ± 18.01 years. Of the 107 lymph node biopsies, 34 cases (31.8%) were reactive lymphadenitis, 41 cases (38.3%) were tuberculosis, 2 cases (1.9%) were non-caseous granuloma, 6 cases (5.6%) were Hodgkin lymphoma, 8 cases (7.5%) were non-Hodgkin lymphoma, 12 cases (11.2%) were metastatic neoplasm and 4 cases (3.7%) were other specific lesions. Conclusion: The commonest cause of cervical lymphadenopathy was tuberculosis, followed by reactive lymphadenitis, lymphoma and metastatic neoplasm.
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To assess efficacy and safety of transurethral cystolithotripsy in the management of large vesical calculi. Adult patients with large vesical calculi [>2.5cm] were selected for this prospective study. Patients with associated urethral stricture and big adenomas were excluded. Stone size was measured on ultrasound in the largest diameter. Patients were operated under spinal or general anaesthesia. Nephroscope with 28 fr sheath was used transurethrally along with 2 cm lithoclast probe. Initial fragmentation was achieved with Swiss lithoclast. Later bigger fragments were dealt with stone punch. In the end all fragments were evacuated with Ellick evacuator. Bladder was drained with Foley's catheter for 24 hours. TURP [transurethral resection of prostate] was done if required. Patients with bigger glands were excluded to restrict operating time. Patients were followed up for two weeks. Forty patients were selected. Mean age of the patients was 55 years [range 18-73 years]. There were 32 males [80%] and 8 females [20%]. Stone size was 4.72 +/- 2.52 cm with range of 2.5-7.0 cm. Five patients had multiple stones, four of them had associated neurogenic bladder. Procedure time ranged from 20-90 minutes [mean 45.8 minutes]. Complete fragmentation of calculi was achieved in all patients. Twelve patients underwent TURP under same anaesthesia. Time consumed on resection of prostate was not included in procedure time. There were no major complications. Transurethral cystolithotripsy is very effective and safe for large vesical calculi [>2.5cm]. It is time consuming but saves patients from hazards of open surgery.
Sujets)
Humains , Mâle , Femelle , Calculs de la vessie/thérapie , Lithotritie/méthodes , Résultat thérapeutique , Cathétérisme , Cystoscopes , Vessie neurologique , Études prospectivesRésumé
Diet plays an important role in treatment of various diseases caused by alteration of humours like Dam [blood] Balgham [phlegm], Safra [yellow bile] and Sauda [black bile] as in Unani medicine. The cure lies only in the supplementation of diet with particular nutritional substances. As regards the hair care, we nourish it from the root with the help of different foods
Sujets)
Humains , Compléments alimentaires , Troubles nutritionnels/complications , Médecine unaniRésumé
Background: Lymphadenopathy is a common manifestation of a large variety of disorders, both benign and malignant. It is essential to define the pattern of disorders presenting primarily as lymph node enlargement in a particular environment. Histopathological examination of the lymph node biopsies is a gold standard test in the distinction between reactive and malignant lymphoid proliferations as well as for detailed subtyping of lymphomas. We designed this study in our population for histopathological evaluation of lymph nodes that might be helpful for clinical management of these lesions. Objective: Histopathological evaluation of lymphadenopathy from excised specimen, in relation to age and sex of the patients, and distribution of the lymph nodes. Materials and Methods: It was a retrospective cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. Lymph node biopsies of all patients of both sexes and all age groups were included. Metastatic lymph nodes associated with evidence of primaries elsewhere in the body were excluded from the study. Total 191 lymph node biopsies were selected for histopathological evaluation. Among these 90 (47.12%) were from males and 101 (52.88%) were from females with male to female ratio being 1:2.1. The age of the patients ranged from 2 to 85 years with a mean age of 35.73 ± 18 years. Results: Cervical lymph nodes were the most common (56%) biopsied group. Of the 191 cases 59 cases (30.89%) were reactive lymphadenitis, 64 cases (33.5%) were tuberculosis, 2 cases (1.05%) were non-caseous granuloma, 11 cases (5.76%) were Hodgkin lymphoma, 22 cases (11.52%) were non-Hodgkin lymphoma, 24 cases (12.57%) were metastatic neoplasm and 9 cases (4.7%) were other lesions. Conclusion: Tuberculosis was the most common cause of lymphadenopathy, followed by reactive lymphadenitis and the cervical group of lymph nodes was most frequently affected.
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Various options are available for treatment of chronic anal fissure, each with its own associated complications. This study aimed to evaluate the efficacy of topical Glyceryl Trinitrate [GTN] for anal fissures in an outpatient setting. A prospective experimental study was carried out at the outpatient department of Surgical Unit IV, Liaquat University Hospital from Aug 2004 to Jul 2005. Total 100 patients fulfilling the criteria of chronic anal fissure were included in the study. Patients presenting with chronic anal fissure but with associated comorbidities were excluded. Data were collected on a designed questionnaire, and analysed using SPSS-10. Sixty women and 46 men were included in the study with a mean age of 30 years. After the end of 8 weeks of treatment, 76 showed healing of fissure and relief in symptoms whereas 20 patients either had improvement in symptoms or did not heal. The commonest side-effect was headache reported by 21 patients. The minimum period of follow-up was one year, and 7 patients had recurrence. Topical 0.2% GTN is an effective first-line agent in managing chronic anal fissure. The associated side effects and recurrence remains a matter of concern.
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Acute appendicitis is the most frequent non-obstetric emergency that require surgery for the period of pregnancy. The aim of the study was to assess Laparoscopic versus Open method of appendicectomy in pregnant patients in respect of benefits and hazards to patients and fetus. Comparative Study. This study was conducted at Alrass General Hospital Saudi Arabia from 1[st] March 2008 to 1[st] June 2010. Pregnant women having acute appendicitis admitted in Alrass General Hospital Saudi Arabia and underwent open or laparoscopic appendicectomy were studied. A total of 118 pregnant women were operated for acute appendicitis. 66[55.9%, n = 118] patients underwent open and 52[44.1%, n = 118] patients underwent Laparoscopic appendicectomy. Mean age +/- SD [range] of patients 23.45 +/- 4.5 years [18-38] in OA [open appendicectomy] group and 22.00 +/- 2.94 years [17-37] in LA [Laparoscopic appendicectomy] group. Mean gestational age was 16.51 +/- 4.17 weeks [11-26] in OA and 18.28 +/- 4.61 weeks [10-27] in LA group. There were no fetal loss in any group. Pre-term delivery occurred in 6[9.1%] patients in OA and in 4[3.7%] patients of LA group. In laparoscopic surgery there is no increased risk to mother and fetus as compare to open surgery
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To compare the results of surgical treatment of chronic anal fissure resistant to conservative management, after anal fissurectomy or lateral internal sphincterectomy. One hundred forty five patients with chronic anal fissure failed to heal with medical treatment admitted in the Department of Surgery Unit II Liaquat University Hospital Jamshoro Sindh Pakistan, from January 2007 to June 2009 were studied. Patients were divided into two groups, 67 patients underwent Fissurectomy [F], and 78 patients underwent open lateral internal sphinterotomy [LIS]. We assessed the patients after median follow up of 12 months, for persistence of symptoms [pain, bleeding], complications and recurrence. All patients become symptoms free within 10 days of surgery. Urinary retention was noted in 3[2.06%] patients, 2[2.98%] in fissurectomy [F] and 1[1.28%] in lateral internal sphincterectomy [LIS] group. Incontinence to flatus was noted in 2[2.98%] patients of 'F' group and 1[1.28%] patient of 'LIS' group. Faecal soiling was noted only in 1[1.49%] patient of 'F' group. Recurrence occurred in 3[4.41%] patients of 'F' group, no recurrence seen in 'LIS' group. Wounds healed within six weeks. Sixty two [91.17%] patients of 'F' and 77[98.71] patients of 'LIS' group were satisfied with treatment. In the treatment of chronic anal fissure lateral internal sphincterectomy is the best surgical technique with very few complications and better patient satisfaction
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Background: Masses in the neck are very common and these may range from inflammatory to neoplastic lesions. Fine needle aspiration cytology (FNAC) is a simple, quick and minimally invasive procedure that is well recognized and widely accepted diagnostic tool in separating inflammatory lesions from cystic and neoplastic lesions of the neck. We designed this study in our populations for evaluation of FNAC of different neck masses and that might facilitate the diagnosis and management of these lesions. Objectives: To find out the frequency of different pathological conditions detected on FNAC, to determine the prevalence of neck masses with respect to age and sex and to assert their organs of origin and the nature of the lesions. Materials and Methods: This study was conducted in the Department of Pathology, Enam Medical College, Savar, Dhaka from January 2009 to August 2010. The patients of any age and either sex with neck masses were included. Total 526 patients with neck swellings were included in this study. Among these 60.6% were females and 39.4% were males with male to female ratio of 1:1.54. The age of the patients ranged from 10 months to 85 years with mean age of 32.52 ±17.01 years. Results: Of the 526 cases 341 (64.8%) were from lymph nodes, 127 cases (24.2%) from thyroid glands, 32 cases (6.1%) from salivary glands, 14 cases (2.7%) from cysts and 12 cases (2.2%) from soft tissues. FNAC revealed that 86.2% of the lesions were non-malignant which included 60.5% of inflammatory lesions and 25.7% of other benign lesions. Malignant lesions were found in 8% of cases and 5.9% of the cases were categorized as indeterminate follicular neoplasm of the thyroid gland. Conclusion: Reactive lymphadenitis is the commonest condition in the neck swellings followed by tuberculous lymphadenitis, nodular goiter and malignant neoplasm, especially metastatic carcinoma.
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Objective: to assess the efficacy of alfuzosin in accelerating spontaneous passage of distal ureteral stone
Material and Methods: sixty patients above 18 years of age from both sexes were randomized in two groups; Inclusion criteria was calculi =10mm in distal ureter [below pelvic brim]. Patients in group A were given 50 mg diclofenac sodium tablets twice a day, whereas, Group B patients received alfuzosin tablets [5mg] twice a day along with diclofenac sodium. Maximum duration of therapy was 4 weeks. Patients in both groups were given intramuscular injection of diclofenac sodium [75mg] as required. They were followed up at one week intervals. Stone expulsion rate, expulsion time, analgesia requirements and need of intervention were recorded and compared in two groups. Adverse effects of drug were also recorded
Results: comparison of age, sex and stone size did not reveal significant difference between the two groups [p>0.05]. Mean stone size in group A and B was 7 .13 mm and 7 .64 mm respectively. Expulsion rate was significantly higher in group B as compared to group A [53.3% vs 26.6% p<0.05]. Mean expulsion time was 9.57 days in group A and 5.93 days in group B [p<0.001]. Similarly requirement of number of analgesic injections was significantly less in group B than group A [mean 1.3 vs 3.5 p<0.05]. Only one patient required intervention in group A No correlation could be found between stone size and expulsion rate in either group
Conclusions: alfuzosin facilitates expulsion of· distal ureteral stones <10mm, reduces expulsion time and lowers analgesic requirement
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This study was conducted to determine the in vitro anti-malarial activity of three medicinal plants, Picrorhiza kurroa, Caesalpinia bonducella and Artemisia absinthium of Pakistan. Different extracts of various parts of these plants were prepared by maceration and percolation, and were evaluated for their antimalarial activity. Aqueous, cold alcoholic and hot alcoholic extracts of Picrorhiza kurroa showed 34%, 100% and 90% inhibition in growth of Plasmodium falciparum, respectively, at 2.00 mg/ml. While aqueous, cold alcoholic and hot alcoholic extracts of Caesalpinia bonducella showed 65%, 56% and 76% inhibition in growth of Plasmodium falciparum, respectively at same concentrations. In the case of Artemisia absinthium, aqueous, cold alcoholic and hot alcoholic extract of Artemisia absinthium showed 35%, 55% and 21% inhibition in growth of Plasmodium falciparum, respectively at 2.00 mg/ml. In our study, extracts of Picrorhiza kurroa were found good for traditional therapy with highly significant results