Varicocelectomy high ligation versus low ligation

To find out the outcome of two modalities in management of varicocele comparing high ligation [Paloma's procedure] and low ligation [Ivanissivich's procedure] This observational descriptive study was carried out in Surgical units of People's Medical College Hospital Nawabshah on 60 patients, belonging to age group of 15 to 36 years from January 2002 to December 2006. Patients with varicocele were divided in two groups of treatment modality equally. Group I comprising 30 patients for high ligation whereas 30 patients were kept in Group II for low ligation. Follow up was carried out for two years but response was poor. Varicocele had been observed on left side in most of the cases [95%]. Three cases [5%] presented in Grade-I, 21 [35%] in Grade-II and 36 [60%] in Grade-III varicoceles. Oligospermia was detected in 15% of cases. Group I patients were apprehensive regarding disappearance of dilatation and hanging veins postoperatively seen in 70% of cases whereas disappearance of veins were seen in 93.34% in Group II patients. Complications like haematoma and hydrocele are seen in Group II patients as compared to Group I. Wound infection and recurrence remained almost the same in both groups. High ligation was better tolerated with less complication but did require more counseling regarding disappearance of dilated veins. Paloma's procedure also does not disturb the normal anatomy of inguinal canal

Earthquake 2005: experience with mass casualties at military hospital, Rawalpindi

A massive earthquake struck North of Pakistan on 8th October 2005. The objective of this study was to evaluate the type of injuries and procedures carried out on the admitted casualties. Descriptive study. Military Hospital, Rawalpindi from 8 Oct to 7 Dec 2006. All the causalities were received at the emergency department. All the patients who needed admission for treatment were included. Patients who had minor injuries not requiring indoor treatment and those, brought in dead, were excluded from this study. The files of admitted patients were analyzed for type of injuries, procedures carried out, complications and causes of death. The data was entered in a computer, and results presented in tabular form in numbers and percentages. The total number of patients received was 1698, out of which 862 [50.8%] were admitted. Within the first three months 651[75.5%] cases were discharged after full treatment. A total of 2268 operations were performed. Out of these, 1025 [45.2%] were major surgeries. 323 [31.5%] plastic surgery procedures, needing colostomies 230 [22.4%] orthopaedic operations, 21[2.0%] patients underwent spinal surgery for blunt abdominal injuries 14 [1.6%] and laparotomies were done with 4 [0.4%]. Sixteen [1.5%] amputations had to be done. Seveteen [2%] patients died in the hospital during admission, while 76 were brought in dead

Otolaryngologic manifestations of gastroesophageal reflux disease

To determine frequency of endoscopic oesophagitis in the patients who complain the chronic laryngopharyngeal disorders in the absence of typical gastroesophageal Reflux Disease [GERD] symptoms. Descriptive study The study was carried out in the department of E.N.T at Nawabshah Medical Centre, Nawabshah over the period of two years [2004 to 2006]. One hundred patients of either sex and in the age group between 25-79 years with symptoms of chronic laryngopharyngeal disorders were selected for study. All patients had physical examination of upper aero digestive tract. Direct laryngoscopy was done to evaluate the status of larynx, however rigid esophagoscopy was done to evaluate the status of esophageal mucosa and biopsies from lower part of esophagus were taken in all patients. Eighty percent of patients with symptoms of chronic laryrigopharyngitis were also suffering from microscopic Oesophagitis. Among the 80% patients 87.5% were having non-erosive oesophagitis while 12.5% were having erosive oesophagitis. In significant number of patients with chronic upper respiratory symptoms resistant to the treatment, there was co existing gastroesophageal disease which could be the cause of the symptoms

Tc-99m DTPA dynamic renal scintigraphy in the evaluation of renal transplants: the importance of perfusion index in the diagnosis of renal allograft rejection

Sixty patients with transplanted kidneys underwent dynamic renal scintigraphy using Technetium-99m DTPA. The Perfusion Index, in particular was found to be valuable in differentiating between the two major renal transplant complications of acute tubular necrosis and acute rejection. In addition, other complications like outflow obstruction, pararenal fluid collections, leakage, etc., were readily diagnosed with a high degree of accuracy

Endothelium-dependent vasodilatation in the perfused mesenteric vascular bed of the rat

A new technique for studying the newly discovered endothelium derived relaxant factor in producing relaxations of vascular smooth muscle cells by using an isolated preparation of perfused mesenteric arterial bed is discussed. The preparation was precontracted with suitable spasmogens and the effect of various vasodilators on this preparation with and without the presence of an intact endothelium was studied. Different receptor specific drugs were used for investigating the nature of this substance. The study confirms the essential role of this substance in the production of relaxations of vascular smooth muscle cells and outlines the suitability of this technique for researching into the nature of this substance

Radionuclide techniques in the diagnosis of primary hyperparathyroidism: the role of technetium 99M-Thallium 20 subtraction scanning

The role of various radionuclide investigations, including parathyroid scintigraphy, bone scintigraphy and serum parathormone estimations in the diagnosis of primary hyperparathyroidism is reviewed briefly. The initial experience with the dual isotope [Tl-201; Tc-99m] subtraction scintigraphy for the preoperative localization of parathyroid adenomas is presented