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Laparoscopic repair of traumatic intraperitoneal bladder rupture is safe and effective technique. We here report case of 49 year male with traumatic intraperitoneal bladder rupture proven by CT urogram after sustaining blunt trauma abdomen injury, repaired by laparoscopy technique. Patient recovered without any complications and was discharged on postoperative day 6 under stable condition. we here by conclude that if bladder injury identified early and conditions if feasible, laparoscopic repair is one of the good options for further management without involving open laparotomy.
RÉSUMÉ
Laparoscopic repair of traumatic intraperitoneal bladder rupture is safe and effective technique. We here report case of 49 year male with traumatic intraperitoneal bladder rupture proven by CT urogram after sustaining blunt trauma abdomen injury, repaired by laparoscopy technique. Patient recovered without any complications and was discharged on postoperative day 6 under stable condition. we here by conclude that if bladder injury identified early and conditions if feasible, laparoscopic repair is one of the good options for further management without involving open laparotomy.
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Background: Pregabalin is gamma amino butyric acid (GABA) structural analogue, effectively used in management of different neuropathic pain, incisional and inflammatory injuries. Current study aimed to evaluate the efficacy of pregabalin 75 mg with a placebo as premedication for post-operative analgesia in patients posted for open Appendicectomy under regional anesthesia. Methods: A randomized controlled trial was conducted on 90 patients undergoing open Appendicectomy under regional anesthesia. The patients were divided in two groups of 45 each: group C (placebo); group P (75 mg pregabalin), drug was administered orally 60 minutes before surgery. The Ramsay sedation scale (RSS) was used for assessment of sedation and the visual analog scale (VAS) was used to determine pain at rest and cough, along with assessment of time required for rescue analgesics on the first post-operative day. Results: The RSS scores were significantly higher in groups P as compared to the controls (p<0.001). Postoperative VAS scores for pain both at rest and on cough were significantly reduced in group P (p<0.001). Rescue analgesic consumption decreased significantly in group P (p<0.001). The time at which first dose of rescue analgesia administered was 4.50±3.04 hours in group C, 10.90±5.37 hours in group P (p<0.001). Conclusions: Pregabalin as premedication prolong the postoperative analgesia in addition to decreased consumption of analgesics.
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@#Syphilis is a sexually transmitted disease and its actual prevalence among Pakistani blood donors is currently unknown. A cross sectional study was conducted at different district healthcare hospitals of Punjab, Pakistan with an aim to evaluate the prevalence and risk factors associated with syphilis in blood donors using immunochromatographic test (ICT) and enzyme linked immunosorbent assay (ELISA). A total (n=1200) blood samples were collected from donors aged 18–65 years. All the information regarding personal data, demographic data and risk factors was collected via structured questionnaire. On the basis of ICT and ELISA, the overall prevalence of syphilis was 3.91% among blood donors. The demographic factors positively linked with syphilis were age (P= 0.000; Odds ratio, OR= 7.18; 95% confidence interval CI= 2.816–18.295) and education status (P= 0.000; Odds ratio, OR= 12.33; 95% confidence interval CI= 3.469–43.849) of donors. Similarly among the risk factors analyzed, marital status (P= 0.012; Odds ratio OR= 2.251; 95% confidence interval CI= 1.206- 4.202) and blood transfusion history (P= 0.030; Odds ratio OR= 1.981; 95% confidence interval CI= 1.083-3.623) were also strongly associated with syphilis. We emphasized the importance of promoting preventive measures for syphilis. The syphilis diagnosis should not be based on a single test. The present study indicates that higher prevalence is alarming for blood donors in Pakistan. Stringent donor screening is highly recommended to ensure maximum safe blood transfusion.
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OBJECTIVE: To study the distribution of cancers among females with particular emphasis on cancer cervix in Kashmiri population, which is geographically and socio‑culturally distinct from the rest of India. MATERIALS AND METHODS: All patient records were screened from January 1, 2009 to December 31, 2011 at Regional Cancer Centre, Srinagar. Most common cancers among females were recorded and analysis of cancer cervix cases was performed. RESULTS: Female cancers comprised of 40% of total cancers with oesophageal and breast cancer as most common malignancies. Cancer cervix did not figure in top ten cancers and only 45 (0.01%) cases were recorded of the total of 3084 adult female cancers. CONCLUSION: We conclude that due to different socio‑cultural and sexual practices, this cancer is highly uncommon in Kashmir and screening or possibly should be directed specifically at only high risk selective subjects.
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Recently there has been growing interest in the relationship between diabetes and QTc. Prevalence of prolonged QTc interval is higher in people with type 2 diabetes as compared to non-diabetic subjects, especially in the presence of autonomic neuropathy. QTc prolongation in diabetic autonomic impairment has been reported by numerous authors and also has been reported to lead to sudden death. The main aim of this study is to estimate the incidence of QTc prolongation in type 2 diabetes mellitus and its relationship to cardiac autonomic neuropathy. From January 2009 to September 2009, we enrolled 150 type 2 diabetic patients attending the Sulaimani diabetic centre. We also enrolled 100 non diabetic control groups. Both group underwent measurement of QT interval, subsequently QTc estimated according to Bazett equation. We also performed 5 cardiovascular autonomic tests including resting heart rate measurement, heart rate variation with inspiration and expiration, valsalva maneuver, blood pressure response to handgrip and standing. Among the 150 cases 13 were found to have prolonged QTc [8.7%], 11 were females 2 were males [p value 0.041]. No one in the control group showed prolonged QTc. Regarding cardiac autonomic neuropathy [CAN], 106 cases had CAN 35, 40 and 31 for early, definite and severe cases, respectively. There was significant correlation between QTc and CAN [p value 0.000] QTc prolongation was significantly related with increasing age [p value 0.010] and female gender [p value 0.041] but no relationship was found with duration of DM [p value 0.520]. Sensitivity of prolonged QTc for detection of CAN was 20%, with specificity and positive predictive value of 98.7% and 92.3%, respectively. We realized that QTc prolongation occur in cardiac autonomic neuropathy due to DM and it´s highly specific for CAN but insensitive. It is significantly correlated with age and gender but no relation found with duration of DM