Role of diagnostic laparoscopy: a study of 58 patients

To evaluate the role of diagnostic laparoscopy in undiagnosed abdominal diseases. Prospective nonrandomized descriptive study. Fauji Foundation Hospital Rawalpindi, from l[st] January 2007 till 31[st] December, 2009. All the patients of undiagnosed intermittent or chronic pain abdomen and other pathologies presenting to the department of surgery who were candidates for laparoscopy were included in the study. Total of 58 patients [42 females and 16 males] were included in the study. Appendicular pathology, abdominal tuberculosis and pelvic inflammatory disease each was found in 8 patients [13.79%] and adhesions in 6 patients [10.33%]. Other less common pathologies included undescended intraabdominal testes, endometriosis, gall bladder pathology and mesenteric lymphadenopathy. In 14 patients [24.13%] no pathology was detected. Diagnostic laparoscopy is an important diagnostic tool in the armamentarium of surgeons which can be employed for diagnosis of obscure abdominal conditions. Where appropriate therapeutic measures if indicated can be adopted at the same time

Schawanoma disguising as a solitary thyroid nodule

Schawannoma is a benign tumor arising from schawann"s cells. Schawannoma is arising from nerve tissue in central and peripheral nervous system is not uncommon, but is rarely found in body organs like pancreas, parotid gland or clinically simulate some other organ pathology. A case of Schawannoma clinically presenting as a solitary thyroid nodule is presented in this case report

Management of vancomycin-resistant enterococci infections

The incidence of enterococci from clinical sources shows a significant increase with properties of intrinsic resistance to many antimicrobials particularly glycopeptides such as vancomycin. Vancomycin-resistant enterococci [VRE] are usually resistant to many antimicrobials and pose a great threat to the patient safety. The possibility of the transfer of the van A gene from enterococci to Staphylococcus aureus has caused much concern among scientists and clinicians. Management options for VRE infections are limited. Empirical therapy to treat VRE infections should be guided according to the local antimicrobial susceptibility patterns of VRE. Newly developed antibiotics like linezolid, daptomycin, quinupristinldalfopristin, have promising effects against VRE. The prudent use of antibiotics, strict guidelines for the use of new antimicrobials, adherence of infection control measures such as surveillance, hand hygiene, environmental disinfection continue to be essential components of the therapeutic management of colonisation and or infection due to VRE. The present study was undertaken to review VRE infections and the therapeutic options for the management of VRE infections

Rupture splenic artery aneurysm

We present a case of ruptured splenic artery aneurysm in 18 years old unmarried girl who presented with severe upper abdominal pain and sudden collapse. Ultrasound abdomen showed free fluid and ultrasound guided needle aspiration confirmed haemoperitoneum. On laparotomy, a 3cm saccular aneurysm of the middle of the splenic artery was noted. With prompt and urgent management the patient survived

Hepatitis C virus infection: an enigma continues

Hepatitis C, caused by hepatitis C virus [HCV], has emerged as a major health problem not only in developing world but also in developed countries. HCV infects approximately 170 million people worldwide. HCV is the most efficiently transmitted through percutaneous exposure to blood, intravenous drug abuse, haemodialysis, nosocomial incidents [colonoscopy], inadequately sterilised medical instruments, high-risk sexual behaviour, body piercing, tattooing and vertical transmission. Most patients with acute HCV infection develop persistent infection and 75-85% patients develop chronic hepatitis. Chronic hepatitis C predisposes patients to progression to fibrosis, cirrhosis and hepatocellular carcinoma. The diagnosis of HCV infection by serological, virological, molecular tools and biopsy is essential in the management of HCV infection. Pegylated interferon a combined with ribavirin has been the mainstay of treatment of HCV infection. Awareness of health care workers and general population is important to curb this silent epidemic. This review is presented as an overview of epidemiology, virology, pathogenesis, clinical manifestations, diagnosis, treatment and prevention of HCV infection

Groin sepsis following lichtenstein inguinal hernioplasty without antibiotics prophylaxis: a review of 100 cases

To see the prevalence of groin sepsis following Lichtenstein inguinal hernioplasty without antibiotics prophylaxis. A prospective observational study. Department of Surgery Fauji Foundation Hospital Rawalpindi from Dec 2002 to July 2004. A total of first consecutive 100 cases of inguinal hernia were included in the study. All patients were subjected to Lichtenstein repair without antibiotic prophylaxis. Prolene mesh was used in all-cases. Three percent of patients developed postoperative wound infection, which was treated conservatively without any significant morbidity. Lichtenstein's repair is an easy procedure with less complication rate even without antibiotic prophylaxis