Prevalence of irritable bowel syndrome and it's risk factors among medical students of Peshawar, Pakistan

Background: Irritable bowel syndrome is a disorder of gastrointestinal tract that is related to psychological dysfunction and is effected by the social, environmental and psychological factors. This study focuses on the various aspects of prevalence, risk factors and outcomes of the irritable bowel syndrome in medical college students

Objectives: To study the prevalence and risk factors of irritable bowel syndrome among medical students of Peshawar, Pakistan

Study design, settings and duration: A cross-sectional study was conducted in Khyber Medical College, Khyber Girls Medical College, Rehman Medical College, Peshawar Medical College, Peshawar from January 2017 to June 2017

Subjects and Methods: A sample size of about 552 medical students were taken by using WHO sample size calculator using 95% confidence interval and 5% margin of error through simple random sampling technique. Data was collected by administering a semi structured questionnaire and analyzed using SPSS version 20

Results: The prevalence of IBS was 13.4% in males and 17.5% in females. IBS was positively associated with factors like stress and sleep disturbance and negatively associated with risk factors like exercise, smoking, living standards, household income and spicy food

Conclusion: Keeping in view of high occurrence of IBS among medical colleges and university students, there is need to aware the students from the possible negative outcomes of this condition

Therapeutic benefits of green tea extract on various parameters in non-alcoholic fatty liver disease patients

Background and Objective: NAFLD affecting up to 30% of the population globally. Drug treatment option are limited with disappointing results. The dietary supplementation in the form of green tea is another option. Our objective was to investigate the effect of Green tea extract [GTE] supplementation on varioi parameters in non-alcoholic fatty liver disease [NAFLD] patients

Methods: This study was conducted Dept. of Medicine of Sheikh Zayed Medical College/Hospital, Rahii Yar Khan from 15 April 2016 to 15 July 2016. Eighty overweight, non diabetic and dyslipidemic patients c NAFLD, diagnosed on the basis of ultrasound and aminotransferases level were randomized for treatmer with capsule GTE SOOmg [n=40] and capsule placebo [n=40] twice a day for twelve weeks. Anthropometri parameters, liver enzymes, inflammatory markers and liver ultrasound imaging were estimated by SPSS-1 pre and post treatment

Results: As compared to placebo, GTE caused a significant improvement in body weight [29.5+/-3.8 t 27.2+/-3.2 kg/m[2] p=0.03], BMI [86+/-10.5 to 80+/-12.4 kg p=0.026], HOMA-IR [4.32+/-2.25 to 3.16+/- 1.6 p=0.0081 lipid profile [i.e. TC: 242.5+/-20.5 to 215.4+/-18.6 mg/dl p=0.005; TG:175+/-22.6 to 145+/-18 mg/dlp=0.003 LDL-C: 155+/-12.5 to 140+/-16.7 mg/dl p=0.011; HDL-C: 36.8+/-6.7 to46.4+/-5.8 mg/dl p =0.001, Aminotransferase: [i.e. ALT: 70.4+/-15.8 to 52.8+/-12.2 IU/L p=0.04; AST:65.8+/-12.4 to 44.3+/- 8.5U/L p =0.002] and Inflammator] markers [hs-CRP: 3.14+/-0.58 to 2.18+/-0.32 p =0.023Adiponectin: 8.46+/-1.02 to 10.55+/-3.42microg/ml p =0.003; GTE also caused a 67.5% regression of fatty liver changes on ultrasound as compared to placebo which is 25% only

Conclusion: GTE therapy resulted in significant improvement in metabolic, chemical, inflammatory and radiological parameters of non-alcoholic fatty liver disease patients who were non-diabetic and dyslipidemic

experience with mesh versus darn repair in inguinal hernias

Background and Objective: The inguinal hernia accounts for 50 percent in old age males. A Lichtenstein type of operation has now become the method of choice in most developed countries but in the developing world traditional simple suture repair is still in common practice in resource limited hospitals due to the scarcity and expensive nature of the commercial prosthetic mesh. Our objective was to compare the rates of complications in Lichtenstein repair to tension free Darn repair

Methods: Ninety two male patients from 20-60 years of age reported for direct or indirect inguinal hernia with open Mesh/Lichtenstein or darn repair in emergency or electively from January 2014 to December 2015 were enrolled in this prospective randomized control trial [RCT]. The primary end point was to compare the surgical site infection, length of hospital stay and hernia recurrence with different techniques

Results: The hospital stay was higher in patients who had Lichtenstein repair, Superficial surgical site infections in cohort A [6.5%] and cohort B [4.36%] were noted. Complications of recurrence in Group-A were [1.5%] as compared to Group-B which had a recurrence of 6.52%

Conclusion: Lichtenstein is more promising in comparison to Darn repair in terms of recurrence in inguinal hernia

Acute renal failure among kalapathar poisoning patients

Background: Kala pathar is a chemical used as hair dye in the developing countries. Cases of trans dermal absorption are reported, but the main concerns are regarding its suicidal intake, as there is no specific antidote for this

Objective: To determine the frequency of acute renal failure in patients with kala pathar [paraphenylene diamine] poisoning

Methodology: This cross sectional study was carried out at Department of Medicine, Sheikh Zayed Hospital, Rahim Yar khan from the period of 1[st] January to 31[st] December 2016. The patients with age 15-50 years with history of kala pathar poisoning either by transdermal or oral ingestion [assessed by history] of any amount were included. The frequency of acute renal failure was labeled where the blood urea level was found more than 30 mg/dl and serum creatinine more than 2 mg/dl.The data was entered and analyzed by SPSS by version 21

Results: In this study there were 65 cases, out of which 47 [72.31%] were females and 18 [27.69%] males. The mean age was 24.35+/-9.8years. The mean duration of kala pathar taken before presenting to the hospital was 5.35+/-0.48 hours. Out of 65 cases 58 [89.23%] had oral intake as compared to 7 [10.77%], trans-dermal absorption. All 7 trans-dermal absorption suffered accidental exposure while out of 58 oral intakes, 54 [93%] took it for suicidal attempt. Acute renal failure was seen in 12 [18.46%] out of 65 cases. Renal failure was common in females affecting 9 [19%] out of 47 cases with p= 0.17. It was significantly higher [19%] in age group less than 30 years [ p= 0.04]. Renal failure was also significantly associated with cases that took it orally, with suicidal intent and their time to presentation to hospital was more than 4 hours with p values of 0.001, 0.02 and 0.03 respectively. There was no significant difference in terms of marital status, however, it was common in un-married with p= 0.08

Conclusion: Kala pathar poisoning is common in our population and acute renal failure is seen almost in every 5[th] cases. Young age, oral intake, suicidal intent and late reporting to hospitals were significantly associated with acute renal failure

Management of congenital talipes equinovarus by the ponseti method - short-term and intermediate effectiveness of the technique and factors affecting outcome

Objective: To evaluate the effectiveness of the Ponseti method of clubfoot management in neonates and infants and to see which factors affect outcome

Study Design: Retrospective study

Place and Duration of Study: Department of Paediatric surgery, Military Hospital, Rawalpindi, from October 2012 to September 2014

Material and Methods: The Ponseti method for the management of congenital talipes equinovarus was applied in children of 7 days to 6 months age. While those with complex neurological problems, pathological clubfeet, syndromic clubfeet and older than 6 months at the time of presentation were excluded from the study

Assessment was done at presentation, at the removal of the last plaster cast and after one-year use of the foot abduction splint

Results: A total of 124 clubfeet of 89 children, including 63 males [70.78%] and 26 females [43.82%] were treated as outdoor cases. Eighteen feet [14.51%] were of rigid [typical] type whilst 106 [85.5%] were of flexible [typical] type. Bilateral involvement was seen in 35[37.31%] children. The mean pretreatment Pirani score was 5.4 and the mean number of plaster casts required was 5.8

The mean Pirani score at 1-year follow-up was 0.5 with successful outcome in 82.3 % of all cases [96.9 % of neonates]. Poor compliance with the use of the foot abduction splint adversely affected outcomes

Conclusion: The Ponseti method of treatment of congenital clubfeet is safe and easy to learn with effective and reproducible results. Early start of treatment and compliance with the use of the foot abduction splint during the maintenance phase are crucial to successful outcome

Otitis media with effusion: Accuracy of tympanometry in detecting fluid in the middle ears of children at myringotomies

Objective: [1] The diagnostic accuracy of tympanometry in detecting fluid in the middle ear space in children with otitis media with effusion by comparing its findings with those of myringotomies. [2] Identify the age group most commonly affected by OME

Methods: This prospective study was conducted at the Department of ENTand Head and Neck Surgery, Postgraduate Medical Institute Hayatabad Medical complex, Peshawar from July 1, 2012 to April 30, 2015. Patients with suspicion of OME underwent tympanometry and later myringotomies. Using Jerger's classification, Type B tympanogram with normal canal volume was considered as conclusive evidence of fluid in the middle ear space. Its findings were compared with those of the respective myringotomies. From the data collected, the accuracy, sensitivity, specificity, positive predictive value and negative predictive values were calculated

Results: A total 117 ears of 63 patients were operated. The age range was 3 to 12 years. The commonest age group [58.7%] affected by OME was 6-8 years. Type B tympanogram with flat curve and normal canal volume was obtained in 71.4% of the ears. Comparison with myringotomy findings showed TP 85, TN 13, FP 5 and FN 14. The diagnostic value of tympanometry was; Sensitivity 85.85%, Specificity 72.22%, PPV 94.44%, NPV 48.14% and Accuracy of 83.76%. P value calculated using chi square test showed that there was significant difference between tympanometry and myringotomy findings in OME [p < 0.05]

Conclusions: OME is common in age group 6-8 years. Tympanogram Type B with normal canal volume is fairly sensitive in diagnosing this condition. However for occurrence of false positive results, final decision regarding management should be made on clinical findings and other supportive audiological tests

Biological screening of Elaeagnus umbellata Thunb

The bark and fruit extracts of Elaeagnus umbellata have been investigated for their antibacterial, anti-fungal, insecticidal and phytotoxic activities. The petroleum ether extracts of the plant showed significant activity against E. faecalis. The activity of dichloromethane extract was also determined significant against S. aureus. The chloroform extract indicated low activity against E. coli, K. pneumoniae, B. subtilis and S. flexenari. The ethyl acetate fraction demonstrated significant activity against K. pneumoniae while methanolic extract exhibited significant activity against E. coli. All extracts showed low phytotoxic activity. The dichloromethane extract exhibited moderate insecticidal activity while other extract indicated low activity

Frequency of difficult and failed intubation in apparently normal patients undergoing elective surgery

To find the frequency of difficult and failed intubation in apparently normal patients undergoing elective surgery. We also aimed to look at sensitivity and specificity of Mallampatti classification in our population. Cross sectional study. Combined Military Hospital, Rawalpindi and Multan from 1[st] May 2013 to 1[st] June 2013. There were 467 patients, who underwent elective surgery with general anesthesia and endotracheal intubation. During their pre-anesthetic visit, we assessed the airway according to Mallampatti score. After endotracheal intubations, frequency of difficult intubations was evaluated [i.e. Grade III and Grade IV] with special emphasis on intubation done by consultant anaesthetist and post graduate trainees followed by frequency of failure of intubation and other complications during intubation were also noted. Furthermore, comparison of Mallampatti with Cormack and Lehane's classification of difficult intubation was done. Difficult intubation in these centers was 4.28% [20/467]. Sensitivity of mallampatti was 98.2%. Incidence of failure of intubation was 0.42% in our study. The frequency of difficult intubation is 4.28% whereas failure of intubation is very low [0.42%] and was observed in special cases only. In our study, the sensitivity of Mallampatti to Cormack and Lehane's classification of intubation was 98.2% which suggests that it is a sensitive predictor of difficult intubation but complete accuracy cannot be determined by using the Mallampatti score

Assessment of measles immunization in children 1-2 year age in district Peshawar, Khyber Pakhtunkhwa Pakistan

To determine vaccination coverage against measles and the factors predicting it. Cross sectional, Analytic. This study was conducted at Peshawar District Khyber Pakhtunkhwa, Pakistan and the duration was 1[st] June 2014 to 20[th] June 2014. The study was carried on sample of 210 children in District Peshawar, Khyber Pakhtunkhwa, Pakistan. The district was first divided into clusters of 105. Out of these 21 clusters were randomly selected. Sample of 10 children aged 1-2 were randomly taken from each cluster. Cluster sampling technique was used and the data was collected by face to face interview using structured Questionnaire as tool. Overall vaccination coverage was 57.6% with a male to female ratio of 50.4% and 49.6% respectively. Mother's Education with vaccination status of Children suggests a strong relationship. Mothers with no education [illiterate] vaccinated 36.3% and mother with education [Literate] vaccinated 82.5% of their children. The Chi-square test is significant [X[2] =45.605; p-value .000]. Parents Education, Household Income and knowledge of mothers about measles vaccination age were found important predicting factors for vaccination status of children

Knowledge of physicians of tertiary care hospitals of Peshawar about Schizophrenia

To assess knowledge of physicians of tertiary care hospitals of Peshawar about schizophrenia. Cross Sectional. This study was carried out at Lady Reading Hospital, Khyber Teaching Hospital and Hayatabad Medical Complex, Peshawar from 10/09/2009 to 10/10/2010. It was cross sectional study conducted at tertiary care hospitals of Peshawar from 10[th] September to 2009 to 10[th] September 2010. 100 Physicians were asked to answer a Performa consisting of two portions namely, General Information and knowledge about Schizophrenia. Ninety Six percent of the physicians who participated in the study were males while four percent were female. Out of 100 physicians, 2% treated more than 10 patients annually, 3% treated 6-9 patients, 12% treated 3-5 patients and 13% treated 1-2 patients annually while 70% physicians didn't treat any diagnosed case of schizophrenia in a year. 6% of the physician diagnosed more than 5 new cases, 18% diagnosed 3-5 new cases and 42% diagnoses 1-2 new cases annually while 34% didn't diagnose any new case in year's time. 44% of physician had good knowledge about schizophrenia while 56% had poor knowledge. Most of the physicians have poor knowledge about schizophrenia

Efficacy of low dose [20 Mg] for the treatment of mild to moderate acne vulgaris

To determine the efficacy and safety of low dose [20 mg] isotretinoin for the treatment of mild to moderate acne for a duration of six to nine months. This was an observational, non-comparative, uncontrolled study. This study was carried out at the Department of Dermatology, Shalarnar Hospital Lahore from 01-1-2010 to 31-12-2013. Six hundred adult patients of either sex with mild to moderate acne and, ages between 15 to 25 years were enrolled. They were treated with a fixed low dose of isotretinoin daily irrespective of weight, for six to nine months. Patients were evaluated clinically at baseline, then monthly during the treatment and follow-up. Of the 600 patients enrolled, 580 completed the study. 94% of patients were completely cured in six months with a cumulative dose of 6237 mg/kg. Treatment was continued for 6% of patients, who still had active acne lesions. The cure rate reached 98.96% at the end of ninth months. Patients were followed for another six months and a relapse rate of 4.48% was observed. Mild cheilitis and xerosis were common. Laboratory abnormalities were mild and transient. Six to nine months treatment with a daily dose of 20 mg/day isotretinoin was found to be effective in patients with mild to moderate acne. The drug was well-tolerated and showed almost negligible clinical and laboratory side effects

Intralesional bleomycin sclerotherapy: an effective treatment of cystic hygroma in children

To study the outcome of intralesional sclerotherapy with injection Bleomycin in cystic hygroma in children. A case series. The department of Pediatric Surgery at Military Hospital, Rawalpindi, Pakistan from Jan 2011 to Dec 2012. All patients with peripheral cystic hygroma [CH] presenting to us, were enrolled in the study. The cyst was aspirated in the operation theater under sedation. Injection bleomycin 0.5 mg /kg diluted in 10-15 cc of distilled water was injected in the cyst at multiple sites. Injection was repeated after every month depending upon the response. A total of 30 patients reported to the department with superficial cystic hygroma, 12 were males [40%] and 18 were females [60%], age ranged from 15 days to 8 years. Cervico-facial was the most common site. Results were assessed in terms of excellent [complete resolution], good [> 50% reduction in size] and poor [< 50% reduction in size]. In 2 patients, complete resolution was achieved after maximum seven shots of intra-lesional bleomycin injections [IBI], while 18/30 [60%] resolved after single dose. Twenty seven patients [90%] resolved completely, 2 [6.6%] had good response, 1 [3.3%] showed poor response. Minor complications were noted which were treated by symptomatic treatment. No major side effects or recurrence were noted in maximum 2 years follow up. Intralesional bleomycin sclerotherapy is safe and effective as primary treatment in cystic hygroma

Analysis of maxillofacial injuries spread over one year period in Karachi sample

This descriptive case series study assessed the spectrum of maxillofacial injuries seen at the Emergency Department of Abbasi Shaheed Hospital, Karachi, Pakistan from March 2009 to February 2010. A total of 1295 patients with maxillofacial injuries were included in the study, of whom 875 [67.6%] were male and 420 [32.4%] female. Injuries were most common 340 [26.25%] in first decade. The most common cause was road traffic collision [611] patients and fall was second most common cause [415] patients. The mandible was the most common bone fractured [309] patients, followed by dentoalveolar [142] patients. There were 73 patients with fractured maxilla. Isolated soft tissue injuries occurred in 578 patients most commonly occurring in the lower third of the face. Most of the maxillofacial injuries were received between 1500 and 2100 hrs, [665] and Saturdays were the busiest days with [242] patients. The collection of data over the one from emergency department regarding the maxillofacial fractures including soft tissues injuries helps us how to manage on early basis and also may guide us regarding the time and day of the week which is busiest time of the emergency department

Single scrotal incision orchidopexy for palpable undescended testis

To retrospectively asses the results of single scrotal incision orchidopexy [SSIO] performed at our centre with ligation of the patent processus vaginalis in children having palpable undescended testes [UDT]. Quasi-experimental with retrospective data. Department of Paediatric surgery Military Hospital Rawalpindi, from April 2007 to December 2011. After making a single transverse incision at superior scrotal border, the testis was identified; gubernaculum and the sac were dissected to the highest level and divided. The testis was places into the scrotum and fixed to the scrotal fascia/skin. All patients were assessed at 2 weeks, 2 months and 6 months post operatively, and then yearly. A total of 38 orchidopexies were performed in 33 patients. The patients' age ranged from 14 months to 7 years [mean: 2.1 years]. Bilateral UDT were found in 5 patients [15.1%]. Operative time ranged from 20 to 45 minutes [mean: 36 minutes]. The single scrotal incision technique was successful in all 38 cases [100%]. All testes were easily fixed in the scrotum. Two patients [5.2%] developed scrotal haematoma and one patient [2.6%] developed stitch abscess. All showed good anatomical and cosmetic results up to a minimum of six months of follow-up. Single scrotal incision orchidopexy for palpable undescended testis is a simple and safe technique. It has shown to consume shorter time and give good cosmetic results

Truncated type II isopentenyl diphosphate isomerase from hyperthermophilic achaeon thermococcus kodakaraensis implicates the necessity of its N-terminal amino acid residues in protein thermostability

The enzyme isopentenyl diphosphate isomerase [IDI, EC 5.3.3.2] interconverts isopentenyl diphosphate and dimethylallyl diphosphate. We had previously cloned Tk-idi gene encoding the thermostable Tk-IDI enzyme from Thermococcus kodakaraensis KOD1. Four putative start codons were found on Tk-idi gene at 123, 213, 297 and 321 positions downstream of the first start codon. In the present work four mutants were obtained by deleting 123, 213, 297 and 321 nucleotides from the 5'-end of Tk-idi gene to obtain Tk-idim, Tk-idim1, Tk-idim2, and Tk-idim3, respectively. When we tried to express these truncated genes in Escherichia coli only Tk-idim was expressed in the active form. The product, Tk-IDIM, was purified and characterized. The molecular mass of the enzyme, estimated by gel filtration chromatography, was 300 kDa which indicated that the truncated enzyme retained the octameric form. The removal of 41 N-terminal amino acids did not exhibit a significant effect on the enzyme activity however, the thermostability of the enzyme decreased. The decrease in thermostability of Tk-IDIM correlated well with the results of circular dichroism [CD] analysis and structural modeling

Clinico-pathological profile of sinonasal masses: study of 90 cases

To determine the clinicopathological profile of sinonasal masses studied at a tertiary care hospital. This descriptive study was conducted at the department ofENT, Head and Neck Surgery, Postgraduate Medical Institute Lady Reading Hospital Peshawar from Sept. 2008 to Aug. 2010, with total duration of 02 years. After admitting the patients'a detailed history was taken and thorough examination of ear, nose, throat and neck was carried out. Necessary investigations were performed. After taking an informed consent all the patients were subjected to proper surgical treatment and specimens were examined by histopathologist. All these patients were followed for minimum of six months duration on monthly basis. This study included 90 cases constituting 49 male and 41 female, with male: female ratio of 1.2:1. The age of the patients ranged from 08-65 years with mean age of 33.13 + S.D 18.67 years. The complaints of these patients were left side nasal obstruction [43.33%], Epistaxis [34.44%] and headache [27.77%]. Incisional biopsy of sinonasal masses was taken in 31 cases [34.44%] while among the surgical procedure antrochoanal polypectomy was the commonest [31.11%]. Histopathological diagnosis was obtained and simple inflammatory polyp was the commonest finding [63.3%] followed by angiofibroma [11.11%]. It is concluded that sinonasal masses mainly present with nasal obstruction, nasal discharge and benign masses predominate. Benign sinonasal masses are best treated with surgical excision

Comparison of lateral internal sphincterotomy with 0.2% glyceryl trinitrate in the management of chronic anal fissure

To compare the effectiveness of topical Glyceryl trinitrate Ointment with Lateral internal Sphincterotomy in terms of relief of pain healing of fissure and absence of bleeding over a period of two months. Randomized controlled trial. Department of Surgery, Combined Military Hospital Peshawar from Feb 2007 to August 2007. This study included 80 patients of chronic anal fissure. Patients were randomly divided in two groups with 40 patients in each group. One group was prescribed with 0.2% GTN Ointment intra anally 4 times a day for 8 weeks in OPD [group A]. Second group was admitted in Surgical ward and lateral internal sphincterotomy was performed on each patient by open technique under general anaesthesia [group B]. In Group A 33 [82.5%] patients had healed fissure at the end of 8 weeks While in group B 37 out of 40 [92.5%] patients had healed fissure at the end of 8 weeks. 0.2% Glyceryl trinitrate can be offered as first line of treatment for chronic anal fissure which means that surgery can be avoided in more than 82% of the patients

Studies of ketoprofen toxicity in avian species

Certain environmental factors are very important to stabilize the wild life; avian diseases, vulture crises and ecological annoyance. This should be fixed scientifically to minimize the health hazards. Thus; we have aimed this project to evaluate effects of toxic dosage levels of Ketoprofen in broiler chickens. Two hundred and twenty five [225] healthy broiler chickens were reared upto 28 days and divided into five groups 25 birds in each group. On day 29[th] four groups were medicated twice a day at dose rate of 50 mg/kg body weight respectively intra-muscularly for four days. Feed and water were provided ad libitum. A physical examination, toxicity and mortality rate were recorded daily. Blood samples was drawn to determination the serum values of Aspartate Transaminase [AST], Alanine transaminase [ALT], Uric Acid, Alkaline phosphatase [ALP], and Creatinine. Postmortem performed on day 41 after all samples taken. In second experiment other 100 birds were divided into five groups comprising of 20 birds in each group. One of the groups was injected I/M Ketoprofen 5mg/kg twice a day. Postmortem performed after medication on 5th day. Based on the necropsy findings and biochemical analysis it was found that Ketoprofen was not safe drug in the avian species. Keeping in view the environmental problem [vultures crises] it is recommended that Ketoprofen which has good pharmacological effects in human medicine should be avoided in veterinary practice

Postoperative outcome of minicholecystectomy and conventional cholecystectomy

To investigate the effects of different incision lengths following elective Cholecystectomy Prospective cross sectional, comparative study. This study was conducted at Surgical Unit II Peoples Medical University of Health Sciences Nawabshah from January 2009 to December 2010. In this study, 100 patients were taken as a sample size. In this study, sampling technique was Purposive, non probability. Main Outcome Measures were postoperative pain, Length of hospital stay, Cost of treatment, Time until return to work, Complications. Most surgeons still prefer the open approach when dealing with common bile duct stone. The technique of open Cholecystectomy might compete with laparoscopic Cholecystectomy in avoiding prolonged operating time and major expenses. Mini-Cholecystectomy requires less operating time, less postoperative pain, and early return to work than standard conventional open Cholecystectorny. There were 37 female and 13 male in MC group, and 42 female and 8 male in CC group. Median age was 55 [range 20-80 years] median BMI was 23 [range 17-30]. 15 patients in MC and 18 patients in CC group were with acutely inflamed gall bladder and remaining were with chronic gall stone disease. In MC group of 50 patients the mean hospital stay was 2.5 days with shortest 1 day and longest 5 days. 35 [70%] patients were discharged within 2 days 10[20%] on 3[rd] and 5 patients remained for 5 days. Minicholecystectomy offers less pain, earlier recovery and better cosmetic results than conventional open Cholecystectomy

Pattern of maxillofacial trauma seen at ENT department of a tertiary care hospital

To determine the pattern of maxillofacial trauma seen at Dept. of Ear, Nose and Throat Head and Neck Surgery of a tertiary care hospital. This descriptive study was conducted at the Department of Ear, Nose, Throat [ENT], Head and Neck Surgery, Postgraduate Medical Institute, Lady Reading Hospital, Peshawar from June 2010 to Dec. 2010. It included 108 cases sustaining maxillofacial trauma. The patients of any age and either sex were included while patients having trauma to other systems besides maxillofacial trauma were excluded from study. The universal rule of ABC [Airway, Breathing, circulation] regarding managing emergency was adopted for all the patients. After stabilizing the patient necessary surgical procedure was performed and concerned departments were consulted. Our study included 108 cases of maxillofacial trauma constituting 97 male and 11 female, with male: female ratio of 8.8:1. The age of the patients ranged from 08-60 years with mean age of 30.55 + S.D 19.88 years. Most of the cases were from rural area [59.3%] and 75 cases [69.4%] were received in first 8 hours of incidence. Fire arm injuries 42% was on top followed by road traffic accidents 25% [n=27]. Majority of cases [90.7%] were homicidal and mandiblular fracture was 49.07% followed by maxillary fractures. It is concluded that homicidal firearm injury is the commonest while road traffic accident is second most common causative factor for maxillofacial trauma. These can be minimized by proper implementation of traffic rules, free education of the people, free availability of essential primary health care, best tertiary care at hospital level and spread of weapon amongst public should be banned