Duodenal perforation due to ingested partial denture

Ingestion of foreign bodies including dentures can be a cause of morbidity and mortality. We report a case of poor-fit denture in an elderly male with pulmonary and musculoskeletal comorbidities, who presented as an acute abdomen. The pin attached to the denture caused perforation of first part of duodenum. The only positive finding prior to surgery was a radiopaque density in the abdominal radiograph of the patient and air under the diaphragm. It is important for all the surgeons dealing with acute care patients to be aware of different designs and constructions of dentures

Gastroesophageal reflux disease; frequency of helicobacter pylori infection

To find the frequency of H pylori infection among the patients of gastroesophgeal reflex disease. Descriptive study. Department of Medicine, Unit-I, Services Hospital, Lahore. One hundred patients with gastroesophageal reflux disease [GERD] were included in this study. For detection and confirmation of helicobacter pylori, endoscopy with antral biopsy was done. Specimens were sent for histopathology, and rapid urease test was performed. Main outcome measures: Frequency of H pylori infection, frequency of regurgitation, dysphagia, nausea, vomiting and haemetemesis. 100 patients who fulfilled the inclusion criteria were taken. There were 65 males and 35 females respectively. Their age ranged from 18 to 48 years. 39 [39%] patients were between 29-38 years while 23 [23%] were of 39-48 years. There were 38 [38%] patients between 18-28 years. The mean age of the patients was 31.79 +/- 7.56. 40 [40%] were found to be H. pylori positive on biopsy and rapid urease test, while 60 [60%] were H. pylori negative. The most common recorded symptom was chest pain/retrosternal burning [90%]. Regurgitation [65%] and nausea [55%] were other common symptoms. Dysphagia and water-brash were present in 40% each. Vomiting [30%], abdominal pain [25%] and cough [20%] were the other symptoms. The least common symptom was haemetemesis [5%]. A causal relationship between GERD and H. pylori infection could not be established. Therefore, routine H. pylori eradication in the treatment of patients with GERD is not recommended

Outcome of total knee arthroplasty with insall Burstein-II prosthesis

Introduction: patients with severe degenerative knee joint disease often require knee arthroplasty to reduce pain, improve stability and restore function. Insall Burstein II prosthesis is posteriorly stabilized condylar prosthesis, which provide posterior cruciate ligament substitution. It was designed to improve range of motion, stair climbing ability and to prevent posterior subluxation

Objectives: evaluate the functional outcome of total knee arthroplasty with IB II prosthesis and evaluate the alignment of prosthetic components by radiological parameters and its correlation with functional outcome Study

Design: it was a case series descriptive study

Setting: department of Orthopaedic Surgery at Shaikh Zayed Hospital, Lahore

Duration of the Study: it was carried out in 3 years form 1st September 2003 to 31" August 2006

Subject and Methods: sixty knees of sixty patients were replaced by using Insall Burstein II prosthesis. Postoperative radiographs were evaluated for alignment of knee and prosthetic components by criteria selected from knee society roentogenographic evaluation system. Functional outcome was evaluated by rationale of knee society knee rating system

Results: prosthetic component was aligned in 93% and mal-alignment in 7% of the cases. There was significant improvement in function score from mean score 33.83 +/- 15.5 to 59.5 +/- i7.7 and knee score from 37 +/- 12.5 to 76.4 +/- 2.2. Postoperative functional score was found correlated with alignment significantly

Conclusion: total knee arthroplasty with I-B-II prosthesis is a safe durable and predictable procedure with proper surgical technique and expertise good alignment and satisfactory functional outcome can be achieved

study of measles cases reported to District Headquarter hospital, Bahawalnagar

To study the measles cases reported to the hospital and measles associated diarrhea and pneumonia in children less than 15 years of age over a period of one year. Hospital-based Prospective Study was conducted at children out patient department of District Head Quarter Hospital Bahawalnagar, which is the main secondary health care facility of the district. The study period was from March, 2005, to February, 2006. Data collecting procedures were based on the questionnaires designed for clinical diagnosis of measles and complications were also recorded. Standard case definitions were used for the diagnosis of Probable Measles, Clinically Confirmed Measles, Measles Associated Diarrhea [MAD] and Measles Related Pneumonia [MRP]. Informed verbal consent was taken from the respondents. Pediatricians filled the questionnaires. All cases of measles were included and the cases that did not meet clinical case definition were excluded from the study. A total of 140 cases of measles were enrolled during the study period of one year. The maximum number of patients, [86] 61.43%, were in the months of April, May, June, July and August. Out of 140 patients, 38 were clinically confirmed of having measles while 62 were grouped as probable measles. There were more females [88] than males [52].The most affected age group was under the age of 3-years with 76 patients [54.28%], 37 [26.43%] cases in 3 to 5 years age group and 27 cases [19.28%] were above 5 years of age, while 17 cases [12.14%] were reported in 6 to 9 months of age. Only 60 cases [42.86%] were immunized against measles while 80 cases [57.14%] were not immunized. Non-immunized children were more likely to suffer from complicated measles [75 [93.75%]] than immunized children [29 [48.33%]]. Diarrhea was the most frequent complication [53.57%, n=75], followed by pneumonia [20.71%, n=29]. The largest proportion [53.33%, n=40] of cases with diarrhea occurred in June, July and August while most Pneumonia with measles cases were reported in February, May and November [55.17%, n= 16]. During follow up of the identified cases of measles, 3 children died due to its complications, two with pneumonia and one with diarrhea giving a fatality rate of 2.14%.Measles is still under reported and its complications are a problem in the region. Occurrence of measles in immunized children reflects partial immunity and / or vaccine failure

Epidemiological risk factors and composition of urinary stones in Riyadh Saudi Arabia

The purpose of this study was to perform the chemical analysis of stones to know the pattern of biochemical composition of stones and to determine epidemiological risk factors for stone formation in Riyadh Saudi Arabia. 307 renal stones were analyzed during one year period from September 2000 to August 2001. These stones were sent to central lab Riyadh for analysis from different hospitals attached to this region. The stones were analyzed by semiquantitative method. The kits supplied by Maascia Bruneli SPA. [Italy] was used for chemical analysis of stones. The powered stones and standards both were analyzed for uric acid, cystine, oxalate, carbonate, phosphate, ammonia, calcium and magnesium contents. Male to female ratio was 5:1. The stone frequency was 2.5 times more in Saudis as compared to non-Saudis. Maximum number of stones were analyzed in peak summer months. Calcium oxalate stones were the commonest followed by uric acid and phosphate stones. No cystine stone was found in the series analyzed. From the study of epidemiological factors it seems that the Saudis are more prone to development of stones. A clear stone season seems to exist in the area corresponding to the summer months. The relative increased frequency of stones in the region indicates that nutritional, environmental and genetic factors play a role in the occurrence of stones

Surgical management of lumbar disc herniation by st and ard laminectomy in a periphery hospital; an experience with 64 patients

To study the outcome of surgical management of lumber disc hemiation by st and ard laminectomy procedure.This study was conducted in a periphery hospital, form March 2000 to July 2002. patient spresenting with bachache and leg pain were thoroughly investigated. For the confirmation of hemiated disc, myelography was performed in 50 patients, CT Scan in 10 patient and MRI in 4 patients. All patients underwent st and ard laminectomy. Patients were followed up after 3-4 weeks. Sixty four patient were operated upon for lumbar disc herniation. The youngest patient was 20 years old while the oldest was 65 years' old. All these patients underwent st and ard laminectomy. Forty six patient were males while eighteen were females. The majority of the patients were in the forth and fifth decade of life. Two patients developed discitis, four patients had dural tear during operation, two patients developed wound sepsis. Results of st and ard laminectomy for lumber disc herniation are favourable