Outcome of fixateur interne in thoracolumbar trauma

Spinal cord injury [SCI] is a devastating condition often affecting young and healthy individuals around the world. This debilitating condition not only creates enormous physical and emotional cost to individuals but also is a significant financial burden to society at large. The Objective was to study the outcome of spinal fixation with fixateur interne in cases of thoracolumbar spinal injuries in terms of neurological recovery and complications. This Descriptive study was conducted at Department of Neurosurgery, Hayatabad Medical Complex and Postgraduate Medical Institute, Peshawar, from March, 2006 to December, 2007 Study included patients admitted in Neurosurgery Ward HMC, with acute traumatic spinal injuries during the above mentioned period who underwent thoracolumbar spinal fixation with fixateur interne. Name, age, sex, other relevant data, history, examination findings and investigation results were recorded. Postoperative outcome was evaluated taking neurological status, and complications like infection, implant failure and other complications into consideration. Follow-up of 6 months was carried out. There were 31 patients, [18 male and 13 female]. Fall from height [48%], road traffic accidents [26%] and crush injuries [26%] caused the trauma. Most common age group was from 21-30 years age. Fractured vertebrae included 2 D11 fractures, 12 D12 fractures, 13 L1 fractures, 3 L2 fractures and 1 L3 fracture. Mean operative time 80 minutes, mean blood loss 200 ml, mean hospital stay 6 days and mortality rate was 0%. Number of patients with Frankel grade A reduced from 27 to 19 and in Frankel grade E increased from 0 to 4 patients. Only one patient had infection and one patient had implant removal. Fixateur interne is a useful and low-cost implant for fixation of thoracolumbar junction injuries with very easy availability and easy operative insertion and little blood loss. It has excellent post-operative outcome in terms of neurological improvement and a very low complication rate. Mortality rate is minimal

Frequency of renal stone disease in patients with urinary tract infection

To determine incidence of renal stone disease in patients with urinary tract infection, this cross sectional study was conducted at Surgical Unit of District Head Quarters Hospital, Charsadda over a period of one year from January to December 2005. One hundred consecutive patients were enrolled in this study. All those patients who presented with urinary symptoms were included. While patients with lower urinary tract stones, upper urinary tract stones with renal failure, renal tumours and previous history of renal stones disease were excluded. The data was obtained and analyzed by filling a specially designed proforma for each patient. All 100 patients were between age ranges of 15-60 years [Mean age 37.5 years]. Infection was present in 79% of cases. The commonest organisms isolated according to culture report were E. Coli [30%], Proteus [19%], Klebsiella [11%], Pseudomonas [7%], Staphylococcus aureus [3%] etc. The frequency of renal stone disease in patients with urinary tract infection was 18.98%. [12.6% in male and 6.3% in female]. Mean age of patients with renal stones was 31.26 years and male to female ratio was 1.5:1. Renal stone disease makes an important group among urinary stone diseases. Urinary tract infection with certain bacteria plays an important role in the synthesis of renal stones. A high incidence can be prevented by adopting a variety of simple conservative measures

Conservative management of mesh site infection in ventral hernia repair

Mesh Hernioplasty is the preferred surgical procedure for abdominal wall hernias and infection remains one of the most common complications of this technique. In some patients the mesh may need removal to overcome infection, where as others may be salvaged by conservative treatment. This study was conducted to assess the outcome of conservative management for mesh site infection in abdominal wall hernia repairs. This study was carried out in Ayub Teaching Hospital Abbottabad Pakistan from Jan 2006 to Dec 2007. Thirteen consecutive cases were included, who developed mesh site infection after abdominal wall hernia repair. Pus or purulent fluid was sent for culture and sensitivity. All patients were treated by intravenous antibiotics and local wound care. Treatment was taken as successful when there was complete resolution of infection and healing of the wound. There were 7 inguinal [53.84%], 4 para-umbilical [30.76%] and 2 incisional hernias [15.38%]. Eight patients were males [61.53%] and 5 females [38.46%]. Median age of the patients was 40 years [range 28 to 52 years]. Staphylococcus aureus was the most commonly found organism causing infection in 8 patients, [76.9%]. Mean hospital stay was 22 days [range 18-26 days]. All cases were effectively treated conservatively without removing the mesh. Polypropylene mesh was used in all of these cases. Conservative management is likely to be successful in mesh site infection in abdominal wall hernia repairs

Experience with splenic trauma in Ayub Teaching Hospital, Abbottabad

This study was carried out to estimate the prevalence, severity and mode of splenic trauma and management technique from amongst the abdominal trauma cases admitted in Ayub Teaching Hospital The study was carried out at Surgery units of Ayub Teaching Hospital, Abbottabad, the only referral hospital for major trauma cases, from July 2001 to Dec. 2002. One hundred consecutive abdominal trauma patients admitted to all surgical units which were followed up through complete documentation were included in the study. Their injuries were classified, treatment strategies outlined and complications were documented. Out of the 100 patients presenting in emergency, 25% presented with blunt and 75% with penetrating trauma. 97 patients underwent laparotomy and 03 treated conservatively. Mean age was 27.26 [range 19-49] years. Out of these cases 19 patients had splenic injury, 6 [31.57%] with Type-I and II while 13 [68.42%] with Type-III and IV. 11[57.89%] of the splenic injuries were due to blunt abdominal trauma and 8 [42.10%] due to penetrating abdominal injuries. 14 [83.6%] of the patients with splenic injury underwent splenectomy and 5[26.3%] splenorrhaphy. The commonest cause of splenic injury was blunt abdominal trauma; Assessment of the severity of splenic injuries at the time of laparotomy resulted in splenic salvage procedures in some cases. Splenorraphy was associated with fewer complications