RESUMO
Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline
f the treatment in this case with extensive femoral bone loss. Revision implant stability was augmented with the use of a cemented femoral stem, screw fixation and the metaphyseal sleeve of an S-ROM modular hip system [DePuy international Ltd]
RESUMO
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